Evolving concepts in MDCT diagnosis of penetrating diaphragmatic injury

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• 作者：David Dreizin (1)
  Peter J. Bergquist (1)
  Anil T. Taner (1)
  Uttam K. Bodanapally (1)
  Nikki Tirada (1)
  Felipe Munera (2)
  
  1. Department of Diagnostic Radiology and Nuclear Medicine ; University of Maryland Medical Center ; R Adams Cowley Shock Trauma Center ; 22 S Greene ; St ; Baltimore ; MD ; 21201 ; USA
  2. Department of Diagnostic Radiology ; University of Miami Leonard Miller School of Medicine ; Jackson Memorial Hospital and Ryder Trauma Center ; 1611 NW 12th Ave ; West Wing 279 ; Miami ; FL ; 33136 ; USA
  
• 关键词：Diaphragm ; MDCT ; Penetrating trauma ; Nonoperative management ; Multiplanar reformats
• 刊名：Emergency Radiology
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：22
• 期：2
• 页码：149-156
• 全文大小：1,300 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Emergency Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1438-1435

文摘

This article reviews current and evolving concepts in the diagnosis of penetrating diaphragmatic injury with multidetector CT (MDCT). As criteria for nonoperative management in the setting of penetrating trauma become more inclusive, confident exclusion of penetrating diaphragmatic injury (PDI) has become imperative. Diagnostic performance of MDCT for PDI has improved substantially with the use of thin sections and multiplanar reformats. Evaluation of injury trajectory in nonstandard planes using 3D post-processing software can aid in the diagnosis. Contiguous injury and transdiaphragmatic trajectory are the best predictors of PDI. Careful appraisal of the diaphragm for defects should be undertaken in all patients with thoracoabdominal penetrating trauma.