胸膜外血肿的X线平片与CT扫描诊断对比(1)
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【摘要】目的探讨研究胸膜外血肿的X线胸片与CT表现，并对比分析其诊断价值。方法 回顾分析43例经外科诊断性穿刺或手术确诊的胸膜外血肿(血肿厚度均≥7mm)的患者的X线胸片与CT扫描结果相比较。结果：定位准确性(肺外/肺内)：X线平片为79.1%，CT为100%；定性准确性：X线平片为48.8%，CT为83.7%。两者分别比较，CT均明显高于X线平片，其差异有统计学意义(P<0.05)。结论：针对胸膜外血肿(血肿厚度均≥7mm)，X线平片作为常规检查有诊断价值，而CT具有断层扫描、密度测量、增强扫描等优势能对其进行更准确地定位、定性诊断。
【关键词】胸膜外血肿；X线摄影；CT扫描；诊断
The contrast in the diagnosis of the extrapleural hematoma with the X-ray and CT scanning CHEN yong-qian ,JING wen-bin,WANG yan-qing,JIA xi-ping,Department of radiation,Deyang NO.2 people hospital,Shichuang Dyang 618000, China
【Abstract】ObjectiveTo explore the manifestation of extrapleural hematoma in the X-ray and CT scanning, and to comparative analysis of the diagnostic value between the X-ray and CT scanning. Methods 43 cases of the extrapleural hematoma(the thickness of hematoma≥7mm) by diagnostic aspiration have been chosen. Their materials of the X-ray and CT scanning were retrospectively analyzed. Results Positioning accuracy (extrapulmonary / lung): the X-ray was 79.1%,; the CT scanning was 100%. Qualitative accuracy: the X-ray was 48.8%; the CT scanning was 83.7%. Both of them were found to compare. The CT scanning was significantly higher than the X-ray. The difference has statistical significance (P<0.05). Conclusion In view of the extrapleural hematoma(the thickness of hematoma≥7mm) diagnosis,the X-ray as a routine examination has some values. But, CT scanning has some advantages in term of diagnosis, such as tomography method, measurement of density, contrast enhanced CT. These advantages can be more accurate localization and qualitative diagnosis of the extrapleural hematoma(the thickness of hematoma≥7mm) .
【Key words】The extrapleural hematoma; The X-ray; CT scanning; Diagnosis
在日常生活中胸部外伤比较常见, 胸膜外血肿是胸部外伤后常见，并且较为重要的X 线征象,其对肋骨骨折具有重要的提示作用, 对迟发性血胸的发生也有十分重要的预测价值。本研究通过对外科确诊患者的相关资料进行回顾性分析，探讨X线平片与CT扫描对此征的诊断价值。
1材料与方法
1.1临床资料选择我院2005年10月—2011年9月的经外科诊断性穿刺或手术确诊胸膜外血肿(血肿厚度≥7mm)患者43例，男28例，女15例，年龄15—67岁，平均42.1岁。所有患者均行X线平片和CT平扫，7例行CT增强扫描。
1.2影像学检查X线平片：常规胸部正位、侧位(或斜位)片。CT扫描：德国西门子公司双排螺旋CT，管电压120KV，管电流120mAs，层厚8mm，层间隔8mm，部分病例行增强扫描、薄层重建或多平面重建。扫描范围为胸部。增强患者选择Nemoto高压注射剂注入非离子型对比剂碘海醇(140mgI/ml)。
1.3影像分析由本科室2名医生分别进行图像分析 ......
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