CT and MRI diagnosis of acute traumatic hepatic rupture: analysis of ten cases / 中华创伤杂志(英文版)

ABSTRACT

OBJECTIVE: In order to verify whether magnetic resonance imaging (MRI) is superior to computed tomography (CT) in the detection and characterization of intrahepatic hematoma in its acute stage, the MRI and CT features of acute traumatic hepatic rupture (ATHR) were retrospectively studied and compared. METHODS: In the 10 cases of ATHR admitted to our institute, 3 were examined with CT, 1 with MRI and 6 with both CT and MRI in the first 24 hours post injury and 9 cases out of the 10 were checked up with MRI in the first week after injury of surgery. The shape of the traumatic lesions, the damages of the intrahepatic vessels and the severity of hepatic rupture displayed with CT and MRI were compared. RESULTS: It was found that in the first 24 hours post injury, 66.6% of hepatic injuries were shown as hypointensity on T1-weighted images and low or high density on noncontrast CT. 100% of the lesions were identified as well-marked hyperintensity on T2-weighted images. Damages of the hepatic and/or portal veins were observed in 7, 4 and 3 cases on T2- and T1-weighted images and noncontrast CT figures respectively. The severity of hepatic injuries were graded in 100%, 66.7% and 44.4%of cases with these 3 procedures respectively. CONCLUSIONS: On the basis of our findings, it is concluded that T2-weighted MRI is a more sensitive and reliable imaging modality in the detection and differentiation of the type and severity of acute hepatic rupture than T1-weighted imaging and noncontrast CT.