目的 探讨MRI对肝脾挫裂伤的诊断价值.方法 回顾分析经临床或手术证实的60例肝脾挫裂伤患者的影像资料.结果 MRI检查显示:肝脏包膜下血肿31例,肝脏实质挫伤19例,肝脏挫裂伤并肝脏内血肿3例,脾脏挫裂伤7例(均为脾脏实质内挫伤),诊断符合率为100.00％；超声检查:共32例,均为肝挫裂伤,其中经MRI检查和临床明确诊断为肝挫裂伤的有30例,符合率为93.75％(30/32)；CT检查:共8例,其中5例患者明确诊断为肝挫裂伤、3例患者可疑肝损伤,经MRI检查和临床确诊1例肝挫裂伤,符合率为75.00％(6/8).结论 MRI是诊断肝脾挫裂伤最好的方法,特别是轻微的肝脏实质内挫裂伤,明显优于超声和CT.%Objective To investigate the value of magnetic resonance imaging (MRI) in the diagnosis of liver and spleen lacerations. Methods MRI and ultrasound data from 60 patients with clinically or surgically confirmed liver and spleen contusion were retrospectively analyzed. Results MRI examination revealed hepatic subcapsular hematoma in 31 cases,hepatic parenchymal contusion in 19 cases,liver contusion associated with hepatic hematoma in 3 cases, and splenic contusion and laceration in 7 cases (splenic parenchyma trauma;coincidence rate,100. 00%). All 32 patients who underwent ultrasound examination had liver laceration. Among them, liver laceration was diagnosed by MRI examination and clinical diagnosis criteria in 30 cases (coincidence rate, 93. 75%). Among 8 patients who underwent CT examination, 5 cases were diagnosed as liver contusion and rupture,3 cases had suspected liver injury,and 1 case was diagnosed as liver laceration by MRI examination and clinical criteria (coincidence rate,75. 00%). Conclusion MRI is superior to ultrasound and CT in the diagnosis of liver and spleen lacerations,especially in the diagnosis of minor laceration of liver parenchyma.
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