Objective To explore the diagnostic values of X-ray and CT examinations for the traumatic diaphragmatic rupture. Methods Totally 17 patients with traumatic diaphragmatic rupture were retrospectively analyzed, who underwent X-ray chest radiograph and 64-slice spiral CT examinations as well as coronal and sagittal imaging by multi-planar reconstruction with GE ADW 4.6 workstation. Results Of the 17 patients, there were 15 ones had the rupture occurred on the left side (93.7%), one case on the right side (6.3%) and the remained one had no diaphragmatic injury;there were 10 ones of diaphragmatic contour discontinuity, 6 ones of intrathoracic hernia, 2 ones of cervical stenosis, one case of hanging sign and two cases of falling viscera sign. Conclusion Routine chest X-ray radiography has difficulty in diagnosing diaphragmatic rupture, while CT multiplanar imaging contributes to determining traumatic diaphragmatic rupture. Diaphragmatic rupture may occur after multiple trauma, and CT with multiplanar reformations has to be used as the routine examination for diagnosing diaphragmatic rupture.%目的:探讨X线与CT在外伤性膈肌损伤的诊断价值.方法:回顾性分析在某院住院的17例外伤性患者,均常规拍摄X线胸部正位片并行64排螺旋CT检查,采用GE ADW4.6工作站进行多平面重建.结果:17例外伤性患者中,15例外伤性膈肌损伤发生于左侧(93.7%),1例发生于右侧(6.3%),1例未见膈肌损伤;在膈肌损伤患者所示征象中,膈肌轮廓不连续10例,胸腔内疝6例,狭颈征2例,悬挂征1例,内脏坠落征2例.结论:常规胸部X线正位片诊断膈肌损伤通常比较困难,CT多平面重建成像有助于诊断创伤后的膈肌损伤;对于多发性外伤的患者,影像科医生应该考虑存在膈肌损伤的可能性,并(或)将CT扫描及多平面重建作为常规检查,以寻找可以诊断膈肌损伤的依据.
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