多普勒超声联合超声造影在创伤性脾破裂快速诊断及临床分级中的价值

摘要

目的:探讨多普勒超声联合超声造影检查在快速诊断创伤性脾破裂及临床分级中的价值.方法:创伤性脾破裂的患者75例,采用多普勒超声联合超声造影及单纯增强CT检查,比较两种检查方案对诊断脾破裂的准确率;并通过造影剂时间-强度曲线观察创伤性脾破裂的造影剂到达时间(AT)、达峰时间(TTP)、峰值强度(PI)及流出时间(WT)等各项影像参数的变化情况.结果:多普勒超声联合超声造影对创伤性脾破裂诊断的准确率与CT增强比较无显著差异(P＞0.05),CT增强对脾破裂临床分级准确率略高于超声联合检查,但差异无统计学意义(P＞0.05);创伤性脾破裂在超声造影检查时间-强度曲线图呈慢上慢下型,而正常脾脏呈快上快下型;脾破裂各分级与正常脾组织造影剂的AT、TTP、WT各指标比较差异无统计学意义(P＞0.05),但脾破裂各分级损伤区间与正常脾组织的PI比较,差异有统计学意义(P＜0.05),正常脾脏PI明显高于各级脾破裂,而在脾破裂各级的Pi按照Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级顺序递减,各级两两比较差异有统计学意义(P＜0.05).结论:多普勒超声联合超声造影检查可实现创伤性脾破裂的快速诊断以及准确分级.%Objective:To investigate the value of Doppler ultrasound combined with enhanced ultrasonography in the diagnosis and clinical classification of traumatic splenic rupture.Methods:75 cases of traumatic spleen rupture underwent Doppler ultrasound,contrast-enhanced ultrasound and contrastenhanced CT examination.Comparing accuracy rate of diagnosing spleen rupture of both detecting plans;observing changes of traumatic spleen rupture AT,TTP,PI and WT by contrast agent time-intensity curves.Results:Accurate rate of Doppler ultrasound angiography for traumatic splenic rupture showed no significant difference with enhanced CT examination (P ＞ 0.05);clinical classification accurate rate of enhanced CT was slightly higher than combined ultrasonography,but no statistically significance (P ＞ 0.05);the traumatic splenic rupture time intensity curve was slow up and slow down,while the healthy spleen one would be fast up and fast down;comparison between spleen rupture classification and healthy spleen tissue contrast agent AT,TTP and WT showed no statistical significance(P ＞ 0.05);while the comparison between spleen rupture classification damage range and healthy spleen tissue IP showed statistical significance (P ＜ 0.05);PI of healthy spleen was obviously higher than various degrees of spleen rupture,and PI follows the descending order of Level Ⅰ,Level Ⅱ,Level Ⅲ and Level Ⅳ,pairwise comparison of all degrees showed statistical significance(P ＜0.05).Conclusion:Doppler ultrasound combined with ultrasound imaging could realize fast and accurate classification of traumatic splenic rupture.