目的讨论多层螺旋CT、3.0T MRI对外伤性脾损伤的诊断价值意义。方法收集外伤性脾损伤患者32例，男22例，女10例，平均年龄42岁。18例为车祸撞击致伤，6例为打击伤，8例为高处坠落伤，29例病例经CT诊断确诊，27例患者手术证实，其中3例CT检查可疑性挫裂伤，最后经MRI和临床确诊。结果脾实质内斑片状高密度影或稍高密度影，脾周新月形等低密度混杂影，是外伤性脾破裂的主要CT表现，MRI检查主要表现脾实质内斑片状长T1长T2异常信号影，边界不清。脾包膜下血肿，CT表现沿脾侧边缘向外新月形低密度影，增强脾实质明显强化，而血肿不强化。脾内血肿呈类圆形或斑片状高密度影。脾撕裂伤在脾实质内见低密度带，MRI表现为脾周外缘长T1长T2的新月形包膜下血肿，脾脏内部斑片状T2WI高信号影或高低混杂信号影。结论多层螺旋CT平扫及增强扫描能显示绝大多数外伤性脾破裂的典型CT表现，并能明确分型，对于轻微的脾实质内挫裂伤，MRI独特的异常信号特征是诊断脾挫裂伤最好的检查方法，明显优越CT及超声检查。%Objective The purpose of the discussion of traumatic splenic injury diagnosis of multi-slice spiral CT value of the diagnosis. Methods Collection in patients with traumatic splenic injury in 32 cases, male 25, female 7 cases, the average age of 45 years of age. For 20 cases of car accident injury, 5 cases of combat injuries for the three cases of falling injury, two cases of injury for the fall, for two cases of stab wounds, all cases diagnosed by CT diagnosis, 27 patients were confirmed by surgery. Results The results of the spleen, such as low-density mixed week crescent shadow, is traumatic rupture of the performance of the main CT. Splenic subcapsular hematoma, showing along the outside edge of the spleen crescent side affect low-density, and enhance the substance of the spleen markedly enhanced, and the hematoma is not enhanced. Splenic hematoma was patchy round or high-density video. Splenic laceration in the spleen parenchyma see low-density zone. Conclusion CT and enhanced CT scan showing traumatic rupture of the performance of a typical CT and clear classification.
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