Value of hypo-perfusion signs of abdominal vessels on enhanced spiral CT in evaluation of hypovolemic shock in severe traumatic patients / 中华创伤杂志

ABSTRACT

Objective To investigate the significance of hypo-perfusion signs of abdominal vessels on enhanced spiral CT in evaluation of hypovolemic shock in severe traumatic patients.Methods Clinical and spiral CT image data of 63 patients with severe trauma treated between January 2008 and December 2011 were reviewed retrospectively.According to the occurrence of shock at 24 hours after spiral CT scan,the patients were divided into shock group (34 cases) and stable group (29 cases).Blood pressure,heart rate,ISS,blood pH value,blood lactate (Lac),and buffer excess (BE) and other indices on admission were analyzed and compared between the two groups.Diameter of abdominal great vessels including aorta,inferior vena cava,superior mesenteric artery and superior mesenteric vein were measured on enhanced spiral CT images as well as their CT values in both early and delayed phase of enhancement.Results The shock group showed significantly higher ISS and blood Lac level,but significantly lower BE as compared with the stable group (P ＜ 0.05).Inferior vena cava in the shock group presented signs of deformity and collapse.Minimal diameters of the four abdominal levels were all shorter in the shock group than in the stable group (P ＜0.01).In the early enhancement on spiral CT,the CT value of superior mesenteric artery was lower in the shock group than in stable group [(133.2 ± 32.4) HU vs (186.3 ± 23.3) HU,(P ＜ 0.05)],while the CT value of inferior vena cava above the upper edge of the liver was significantly higher in shock group than in stable group [(133.4 ± 20.3) HU vs (112.0 ± 21.9) HU,(P ＜ 0.01)].In the delayed enhancement on spiral CT,the CT value of each vessel presented no statistical differences between the two groups.Conclusion Some hypo-perfusion signs of abdominal vessels on enhanced CT have some reference value on the early diagnosis of hypovolemic shock in severe traumatic patients.