MSCT findings of traumatic pancreatic injury / 实用放射学杂志

ABSTRACT

Objective To assess the value of MSCT in the diagnosis of traumatic pancreatic injury.Methods The clinical and MSCT examination data of 38 patients with pancreatic injury admitted to our hospital were retrospective reviewed.Radiographic pancreatic injuries were classified as superficial or deep lesions,according to the depth of the injury to pancreas.Superficial lesions were defined as the hematomas or lacerations <50% of thickness of pancreas,deep lesions as the hematomas or lacerations >50% of thickness of pancreas.Results In 38 patients,32 patients underwent operative treatment,and other 6 patients underwent nonoperative treatment,including 20 patients with superficial injury and 18 patients with deep injury.The overall diagnostic coincidence rate of CT was 89.5%(34/38),and diagnostic coincidence rate for deep injury was 100%(18/18)with injury of the main pancreatic duct.Five cases of pancreatic injury were detected by CT enhancement and post-processing technique,and CT examination was considered negative in 4 cases of superficial injury.CT showed intrapancreatic or peripancreatic hematomas in 16 cases,pancreatic tear or laceration in 17 cases,pancreatic contusion in 10 cases, peripancreatic pseudocyst in 11 cases,dilation of the main pancreatic duct in 3 cases,traumatic pancreatitis in 20 cases and peripancreatic infection with abccess in 4 cases.Pancreatic injury presented as pancreatic or peripancreatic hematomas in early stage (within 7 days)and subsequently evolved into pancreatic tear or laceration and pseudocyst.Pancreatic injury was located in the pancreatic head in 10 cases,both in pancreatic head and neck in 1 case,in pancreatic neck in 10 cases,both in pancreatic neck and body in 1 case,in pancreatic body in 2 cases,both in pancreatic body and tail in 7 cases and in pancreatic tail in 7 cases.Pancreatic contusion was mainly located in pancreatic head (8/10, 80%).19 cases of simple pancreatic injury and 19 complex ones were showed in this study.Conclusion The diagnostic coincidence rate of CT for deep pancreatic injury is high with dilatation of the main pancreatic duct.CT findings of pancreatic injury are related to the time,site and degree of the pancreatic injury.CT enhancement and post-processing technique can improve diagnostic rate.