medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-2020-1-96-104medvis-891Research ArticleДЕТСКАЯ РЕНТГЕНОЛОГИЯPEDIATRIC RADIOLOGYМультиспиральная компьютерная томография легких при политравме у детейMultispiral computed tomography of the lungs with polytrauma in childrenhttps://orcid.org/0000-0002-3235-8854АхадовТ. А.AkhadovT. A.

доктор мед. наук, профессор, руководитель отдела лучевых методов диагностики 

119180 Москва, ул. Большая Полянка, д. 22, Российская Федерация

Тел: +7-495-633-58-03, +7-915-332-20-87

Doct. of Sci. (Med), Professor, head of radiology department

Phone: +7-495-633-58-03, +7-915-332-20-87 119180 Moscow, Bol’shaya Polyanka str, 22, Russian Federation

akhadov@mail.ruhttps://orcid.org/0000-0001-9418-4418КарасеваО. В.KarasevaO. V.

доктор мед. наук, заместитель директора по науке 119180 Москва, ул. Большая Полянка, д. 22, Российская Федерация 

Тел.: +7-495-633-58-28

Doct. of Sci. (Med), Deputy Director for Science

Phone: +7-495-633-58-28 119180 Moscow, Bol’shaya Polyanka str, 22, Russian Federation 

karaseva.o@list.ruhttps://orcid.org/0000-0002-2910-3711МельниковИ. А.Mel'nikovI. A.

канд. мед. наук, врач-рентгенолог отдела лучевых методов диагностики 119180 Москва, ул. Большая Полянка, д. 22, Российская Федерация 

Тел.: +7-495-633-58-00 доб. 1689

Cand. of Sсi. (Med.), radiologist

Phone: +7-495-633-58-00 ad. 1689 119180 Moscow, Bol’shaya Polyanka str, 22, Russian Federation 

iliamed@inbox.ruhttps://orcid.org/0000-0002-9103-9191КостиковаТ. Д.KostikovaT. D.

врач-рентгенолог отдела лучевых методов диагностики 119180 Москва, ул. Большая Полянка, д. 22, Российская Федерация 

Тел.: +7-495-633-58-00 доб. 1488

radiologist

Phone: +7-495-633-58-00 ad. 1488 119180 Moscow, Bol’shaya Polyanka str, 22, Russian Federation 

kostikovatd@gmail.comhttps://orcid.org/0000-0001-9862-3609АхлебининаМ. И.AkhlebininaM. I.

врач-рентгенолог отдела лучевых методов диагностики 

119180 Москва, ул. Большая Полянка, д. 22, Российская Федерация 

Тел.: +7-495-633-58-00 доб. 1746

radiologist

Phone: +7-495-633-58-00 ad. 1746 119180 Moscow, Bol’shaya Polyanka str, 22, Russian Federation 

kostikovatd@gmail.comhttps://orcid.org/0000-0002-4627-9874УблинскийМ. В.UblinskiyM. V.

канд. биол. наук, научный сотрудник 119180 Москва, ул. Большая Полянка, д. 22, Российская Федерация 

Тел.: +7-929-620-21-77

Cand. of Sсi. (Biol.), researcher

Phone: +7-929-620-21-77 119180 Moscow, Bol’shaya Polyanka str, 22, Russian Federation 

maxublinsk@mail.ruНИИ неотложной детской хирургии и травматологии ДЗ г. МосквыРоссияClinical and Research Institute of Emergency Pediatric Surgery and TraumaRussian Federation202001052020241Медицинская визуализация 2020№196104Copyright © Ахадов Т.А., Карасева О.В., Мельников И.А., Костикова Т.Д., Ахлебинина М.И., Ублинский М.В., 20202020Ахадов Т.А., Карасева О.В., Мельников И.А., Костикова Т.Д., Ахлебинина М.И., Ублинский М.В.Akhadov T.A., Karaseva O.V., Mel'nikov I.A., Kostikova T.D., Akhlebinina M.I., Ublinskiy M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/891Введение

Введение. Мультиспиральная компьютерная томография (МСКТ) более чувствительна, чем рентгенография груди, для выявления легочных, плевральных и костных повреждений у пациентов с политравмой. Высококачественные мультипланарные реконструкции легких привнесли дополнительную информацию к диагностическим возможностям метода.

Цель исследования

Цель исследования: анализ данных, полученных при проведении МСКТ грудной клетки у детей с политравмой. 

Материал и методы

Материал и методы. Исследовано 147 детей в возрасте от 6 мес до 17 лет с повреждениями груди в структуре политравмы. МСКТ выполнена на томографах Philips Brilliance 16 и 64.

Результаты

Результаты. У исследованных 147 пострадавших основной причиной травмы были дорожно-транспортные происшествия (n = 91 – 61,9%), причиной остальных – падение с высоты (56 – 38,1%). В 80% случаев травма была тяжелой, сочетанной с повреждением не только легких и грудной клетки, но и других частей тела: голова, живот, таз и конечности. Среди 147 пострадавших у 70% пациентов диагностированы повреждения легочной паренхимы в виде ушибов, реже разрывов; пневмоторакс был обнаружен в 30% случаев, гемоторакс – в 15%.

Заключение

Заключение. МСКТ значительно улучшает обнаружение легочных повреждений при тупой травме груди в связи с высокой информативностью повреждения костных структур, мягких тканей и сосудов, возмож ностью получения мультипланарных и объемных реконструкций изображений. Она позволяет иденти фицировать ушибы легких и дифференцировать участки ателектаза или разрывов, оценивать и рассчитывать их площади и объемы, а поэтому должна всегда использоваться в качестве метода первичной диагностики у пациентов с политравмой.

Introduction

Introduction. MDCT is more sensitive in pulmonary, pleural and bone injuries detection in patients with polytrauma than chest radiography. High-quality multiplanar reconstructions brought additional information to the diagnostic capabilities of this method.

Purpose

Purpose. Purpose of this publication was to analyze the data obtained during chest MDCT in children with polytrauma.

Material and methods

Material and methods. 147 children aged from 6 months to 17 years with polytrauma and chest injuries were studied. MDCT was performed on Philips Brilliance CT 16 and 64.

Results

Results. We retrospectively evaluated CT and clinical data of 147 patients, the main reason of polytrauma were traffic accidents (n = 91 – 61.9%), the rest was caused by fall from a height (56 – 38.1%). In 80% of cases the injury was severe and complex with not only lungs and chest damage, but also with other parts of the body: the head, the stomach, the pelvis and the limbs. Among 147 patients, pulmonary parenchyma damages in the form of injuries, less gaps, were detected in 70% of cases, pneumothorax – in 30% of cases, hemothorax – in 15%.

Conclusion

Conclusion. MDCT significantly improves the detection of pulmonary damage in blunt thoracic trauma due to better visualization of bone, soft tissues and blood vessels damage and the possibility of obtaining multiplanar image reconstructions. MDCT allows to identify lung contusions and to differentiate areas of atelectasis and tears, to evaluate and calculate their volumes, and therefore should always be used as a primary imaging method in patients with polytrauma.

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The authors declare that there are no conflicts of interest present.