CT characteristic findings of pancreatic rupture caused by closed abdominal trauma / 中华放射学杂志

ABSTRACT

Objective To study CT characteristic findings of pancreatic rupture caused by closed abdominal trauma.Methods The clinical and CT data of 6 patients with pancreatic rupture caused by closed abdominal trauma were analyzed retrospectively.CT plain scan and the tripple-phased enhancement scan were performed,multi-planar reformation(MPR)and maximum intensity projection(MIP)were used after CT scanning.Thin slice of CT scan and post-processing technique of imaging were used furthermore.Results The rupture of pancreatic neck and tail were shown in 2 cases,the rupture of pancreatic head and body in 1 case.Main CT findings were such as following(1)Hematomas in pancreas or in pancreatic surrounding tissues were shown in 6 cases,they were hyperintensity or slight hyperintensity in plain scan and were not enhanced in three-phase dynamic scan of pancreas.(2)Pancreatic splits,which were relative hypointensity after administration of CT contrast agent in the pancreatic phase,were found in 6 cases,they were like slit-shaped or wedge-shaped or pancreas separated completely in situs.In the pancreatic phase,pancreas parenchyma enhanced obviously but hematoma in the splits did not enhanced,and this drew the outline of pancreatic splits clearly.(3)Contrast agent in the pancreatic hematomas,which leaked from vessels of pancreas,were shown in two patients,like dot or nodule or pond,were highly intensity in artery phase,and there were more leaking of contrast agent in the pancreatic phase,whose intensity was same as abdominal aorta in the same slice image.In the delayed phase,the volume of leaking contrast agent enlarged and they had higher intensity while intensity of abdominal aorta in same slice image decreased obviously.(4)Dilation of the Wirsung duct,which was like curved-tube,was shown in one patient.(5)Meanwhile the contusion of liver,kidney or spleen with pancreatic rupture were found in 4 patients.Conclusion The pancreatic rupture has typical CT findings.It is helpful to improve the accuracy rate of diagnosis with reasonable scanning techniques and understanding correctly CT appearances of pancreatic rupture.