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【medical-news】腹部外伤的首选影像学检查手段是

CT, not ultrasound, may be best for abdominal trauma
Large study finds plenty of injuries among patients with negative ultrasound scans
CT,而非超声,是腹部外伤的最佳影像学检查手段
大样本研究发现很多腹部损伤病人超声检查显示为隐性
Patients with blunt abdominal trauma may benefit from going directly to CT imaging rather than having an initial ultrasound scan.
腹部钝伤病人直接进行CT检查,而非超声初诊对于病人更加有利。
In a study of 4000 patients screened for blunt abdominal trauma, researchers found that those presenting with hematuria or fractures of the ribs, lumbar spine, or pelvis were at high risk for abdominal injuries, even when ultrasound was negative. Of 3680 patients with negative ultrasound, 637 had abdominal injuries, some of which required surgery.
在一项进行腹部钝伤的4000病人的筛查中,研究者发现血尿、肋骨骨折、椎体骨折、骨盆骨折病人即使B超检查阴性时,也很可能伴发腹部损伤。3680例B超阴性的病人中,637例病人具有腹部钝伤,部分病例需要手术治疗。
According to author Dr. Claude B. Sirlin, an assistant professor of radiology at the University of California, San Diego, initial CT would have found 79% of the injuries that were missed. Only 16% of CT exams would have been unnecessary.
根据加利福尼亚大学放射学博士Claude Sirlin教授,漏诊病例的79%都可以通过初诊CT发现。只有16%的病例做CT是没有必要的。
Whenever a patient at high risk for hematuria or the aforementioned fractures undergoes ultrasound as the first diagnostic modality and results are negative, CT or other tests should corroborate the findings, he said.
无论什么时候,如果病人血尿,或者骨折,初诊超声检查阴性时,CT或者其他检查可以证实这一结果是否正确。
"A routine double-check with CT on some patients would virtually eliminate false negatives," Sirlin said.
常规进行CT检查可以消除这种假阴性。
Dr. John McGahan, director of abdominal imaging at UCSD, said the study provides convincing evidence that ultrasound is less sensitive than CT for detecting injuries resulting from blunt abdominal trauma.
John McGahan博士是UCSD的腹部成像专家,说本研究以确切的证据说明了在检出腹部钝伤方面,超声的敏感性低于CT。
The UCSD investigators conducted another study in the same patient population to assess the most common diagnostic drawbacks that undermine the accuracy of screening ultrasound in blunt abdominal trauma. They found that the most common sonographic pitfalls were bowel mimicking free fluid, fat simulating hemorrhage, and nontraumatic liver lesions.
UCSD正在同期进行的另一项研究仍然是针对这一人群,目的是寻找造成腹部钝伤病人超声诊断正确性下降的原因。
"Awareness of common pitfalls will decrease the need for follow-up tests," said lead author Dr. Michele A. Brown, an assistant professor of radiology. "However, because some findings cannot be distinguished from injury, any indeterminate finding should be pursued with additional studies to exclude injury."
知道一项检查手段的缺点,就可以减少随访的需要,但是由于一些发现与外伤难以鉴别,因此需要进一步的检查来证实。
Technical maneuvers such as filling the stomach or adjusting gain settings could clear things up, Brown said. Another important limitation is the detection of injuries without hemoperitoneum, particularly retroperitoneal and enteric injuries.
一些技术方面的措施,例如充盈胃,或者改变检查姿势,可以排除部分问题。其他的一个重要局限性就是发现那些没有腹膜腔积血损伤,特别是后腹膜腔和肠腔的损伤。 不是搞B超的。感觉B超价钱便宜,在小肝癌方面甚至优于CT,但是在腹部外伤,尤其是空腔脏器的损伤方面,肯定是要稍逊一筹的。 [标签:content1][标签:content2]

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作者:admin@医学,生命科学    2011-06-03 17:11
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