关键词：膀胱；破裂；体层摄影术,X线计算机
【摘要】 目的 确定闭合性腹膜内型膀胱破裂的CT诊断价值。方法 对9例闭合性腹膜内型膀胱破裂的CT资料和临床处理进行回顾性分析。结果 所有9例腹膜内型膀胱破裂，CT均明确诊断。CT显示腹膜腔内低密度液体积聚9例，其CT值比血液低，主要分布在膀胱侧隐窝、盆腔陷凹、结肠旁沟、肝脾周围和肠袢内。膀胱壁局部缺损3例，泪滴状变形2例；其他支持膀胱破裂的CT征象包括：膀胱充盈不良8例，膀胱壁挫伤4例，膀胱内血凝块6例。结论 在创伤情况下，腹膜腔内出现CT值比血液小的低密度液体积聚，强烈提示尿外渗，根据尿外渗的分布范围，CT还可以区别腹膜内和腹膜外型膀胱破裂。CT有时还可以观察到膀胱破裂的准确位置，有利于手术修补。
CT diagnosis of intraperitoneal bladder rupture with blunt abdominal trauma
KONG Fanbin.
(Department of CT, the First People′s Hospital of Xuzhou ,Jiangsu Province, Xuzhou 221002, China)
【Abstract】 Objective To evaluate CT examination in the diagnosis of IPBR caused by blunt abdominal trauma. Methods All CT and clinical data of 9 patients with IPBR were reviewed retrospectively. Results IPBR was detected on CT scans in all 9 patients. CT findings of IPBR included low -attenuation free intraperitoneal fluid collections in the lateral paravesical fossae, the pericolic space, the cu de sac of the pelvis, Morison′s pouch ,the perihepatic space,the perisplenic space and interspace of bowel loops in 9 cases with a lower CT density compared with pure blood. The disruption of the bladder wall was located by CT scan in 5 cases: high-attenuation bladder wall with focal defect in 3 cases and a tear drop-like deformity of the bladder in 2 cases. Other CT findings supporting the diagnosis of IPBR included an underfilled bladder in 8 cases, bladder contusion in 4 cases, and blood clots within the bladder in 6 cases. Conclusion The presence of intraperitoneal fluid with a CT density less than that of pure blood strongly suggests extravasated urine in the trauma. Intraperitoneal and extraperitoneal rupture can be distinguished based on location of extravasated urine seen on CT scans.The precise localization of the ruptured bladder wall may be demonstrated by CT scan, which is valuable for surgical treatment.
......
您现在查看是摘要页，全文长 10217 字符。