CT in blunt liver trauma
CT in blunt liver trauma
复制标题
DOI：
10.1148/rg.251045079
复制
发表时间：
2005-01-01
期刊：
影响因子：
5.5
通讯作者：
Kang, HK
中科院分区：
文献类型：
--
作者：
Yoon, W;Jeong, YY;Kang, HK
在血流动力学稳定的钝性肝外伤患者中，非手术治疗已成为标准的治疗方法。在过去十年中，螺旋计算机断层扫描（CT）在钝性肝外伤的诊断和治疗中的应用是导致从常规手术治疗向非手术治疗这种显著转变的主要原因。对于血流动力学稳定的钝性肝外伤患者，CT是评估的首选诊断方式，它能够准确地帮助识别肝实质损伤，有助于量化腹腔积血的程度，并揭示其他腹部器官、腹膜后结构以及胃肠道的相关损伤。钝性肝外伤的CT特征包括撕裂伤、包膜下或实质内血肿、活动性出血、肝静脉周围损伤、门静脉周围低密度以及下腔静脉变扁。放射科医生熟悉由美国创伤外科协会基于这些CT特征建立的肝损伤分级系统是很重要的。CT在评估钝性肝外伤的延迟并发症方面也很有用，这些延迟并发症包括延迟性出血、肝或肝周脓肿、创伤后假性动脉瘤和胆道出血，以及诸如胆汁瘤和胆汁性腹膜炎等胆道并发症。对于高级别肝损伤患者需要进行随访CT检查，以识别需要早期干预的潜在并发症。（美国放射学会，2005年）
Nonsurgical treatment has become the standard of care in hemodynamically stable patients with blunt liver trauma. The use of helical computed tomography (CT) in the diagnosis and management of blunt liver trauma is mainly responsible for the notable shift during the past decade from routine surgical to nonsurgical management of blunt liver injuries. CT is the diagnostic modality of choice for the evaluation of blunt liver trauma in hemodynamically stable patients and can accurately help identify hepatic parenchymal injuries, help quantify the degree of hemoperitoneum, and reveal associated injuries in other abdominal organs, retroperitoneal structures, and the gastrointestinal tract. The CT features of blunt liver trauma include lacerations, subcapsular or parenchymal hematomas, active hemorrhage, juxtahepatic venous injuries, periportal low attenuation, and a flat inferior vena cava. It is important that radiologists be familiar with the liver injury grading system based on these CT features that was established by the American Association for the Surgery of Trauma. CT is also useful in the assessment of delayed complications in blunt liver trauma, including delayed hemorrhage, hepatic or perihepatic abscess, posttraumatic pseudoaneurysm and hemobilia, and biliary complications such as biloma and bile peritonitis. Follow-up CT is needed in patients with high-grade liver injuries to identify potential complications that require early intervention. (C) RSNA, 2005.