Blunt traumatic injuries of the lung parenchyma, pleura, thoracic wall, and intrathoracic airways: Multidetector computer tomography imaging findings

被引:62
作者
Sangster G.P. [1 ]
González-Beicos A. [3 ]
Carbo A.I. [1 ]
Heldmann M.G. [1 ]
Ibrahim H. [2 ]
Carrascosa P. [4 ]
Nazar M. [4 ]
D'Agostino H.B. [1 ]
机构
[1] Department of Radiology, LSUHSC-S, Shreveport, LA 71130
[2] Department of Pediatrics, LSUHSC-S, Shreveport, LA 71130
[3] Department of Radiology, Brigham and Women's Hospital, Boston, MA
[4] Diagnostico Maipú, Buenos Aires, Av. Maipú
关键词
Blunt trauma; Chest; Multidetector computed tomography;
D O I
10.1007/s10140-007-0651-8
中图分类号
学科分类号
摘要
This pictorial review discusses multi-detector computed tomography (MDCT) cases of non-vascular traumatic chest injuries, with a brief clinical and epidemiological background of each of the pathology. The purpose of this review is to familiarize the reader with common and rare imaging patterns of chest trauma and substantiate the advantages of MDCT as a screening and comprehensive technique for the evaluation of these patients. Images from a level 1 trauma center were reviewed to illustrate these pathologies. Pulmonary laceration, pulmonary hernia, and their different degrees of severity are illustrated as examples of parenchymal traumatic lesions. Pleural space abnormalities (pneumothorax and hemothorax) and associated complications are shown. Diaphragmatic rupture, fracture of the sternum, sternoclavicular dislocation, fracture of the scapula, rib fracture, and flail chest are shown as manifestations of blunt trauma to the chest wall. Finally, direct and indirect imaging findings of intrathoracic airway rupture and post-traumatic foreign bodies are depicted. The advantage of high quality reconstructions, volume rendered images, and maximal intensity projection for the detection of severe complex traumatic injuries is stressed. The limitations of the initial chest radiography and the benefits of MDCT authenticate this imaging technique as the best modality in the diagnosis of chest trauma. © 2007 Am Soc Emergency Radiol.
引用
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页码:297 / 310
页数:13
相关论文
共 37 条
[1]  
Omert L., Yeaney W.W., Protetch J., Efficacy of thoracic computerized tomography in blunt chest trauma, Am Surg, 67, pp. 660-664, (2001)
[2]  
Exadaktylos A.K., Sclabas G., Schmid S.W., Schaller B., Zimmermann H., Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with "normal" chest radiograph?, J Trauma, 51, pp. 1173-1176, (2001)
[3]  
Kanz K.G., Korner M., Linsenmaier U., Et al., [Priority-oriented shock trauma room management with the integration of multiple-view spiral computed tomography], Unfallchirurg, 107, pp. 937-944, (2004)
[4]  
Miller L.A., Chest wall, lung, and pleural space trauma, Radiol Clin North Am, 44, pp. 213-224, (2006)
[5]  
Mullinix A.J., Foley W.D., Multidetector computed tomography and blunt thoracoabdominal trauma, J Comput Assist Tomogr, 28, (2004)
[6]  
Kang E.Y., Muller N.L., CT in blunt chest trauma: Pulmonary, tracheobronchial, and diaphragmatic injuries, Semin Ultrasound CT MR, 17, pp. 114-118, (1996)
[7]  
Shanmuganathan K., Mirvis S.E., Imaging diagnosis of nonaortic thoracic injury, Radiol Clin North Am, 37, pp. 533-551, (1999)
[8]  
Wanek S., Mayberry J.C., Blunt thoracic trauma: Flail chest, pulmonary contusion, and blast injury, Crit Care Clin, 20, pp. 71-81, (2004)
[9]  
Zinck S.E., Primack S.L., Radiographic and CT findings in blunt chest trauma, J Thorac Imaging, 15, pp. 87-96, (2000)
[10]  
Mayberry J.C., Imaging in thoracic trauma: The trauma surgeon's perspective, J Thorac Imaging, 15, pp. 76-86, (2000)