@article{oai:twinkle.repo.nii.ac.jp:00016820,
 author = {NAKAGAWA, Takao and YOKOYAMA, Toshimitsu and SUGA, Hiroyasu and DEGUCHI, Yoshizumi and HASEGAWA, Yasuhiro and MURAOKA, Ryusuke and ISHIKAWA, Masatake and SUZUKI, Tadashi},
 issue = {9/10},
 journal = {東京女子医科大学雑誌},
 month = {Oct},
 note = {肝・脾のような実質臓器の損傷に対するcomputed tomography (CT)の所見が手術所見とほぼ一致することは,最近の報告により明らかになっているが,CT所見は実質臓器の損傷を間接的にとらえているのであって,損傷による侵襲の程度を直接とらえている訳ではなく,CT所見から手術適応を判定できるかどうかについては十分な検討がなされていない.肝・脾鈍的損傷で造影CTを施行した自験例33例(肝損傷:21例,肝・脾合併損傷:2例,脾損傷:10例)について,CT所見から手術適応の判定が可能かどうかをretrospectiveに検討し,以下の結論を得た.1)CT所見から,損傷の存在は1損傷部位を除きすべて確認できた.2)CT所見と手術または腹腔鏡所見を比較できた12例では,損傷程度は両所見でほぼ一致していた.3)肝・脾損傷を,CT所見で日本外傷学会肝・脾損傷分類にしたがって分類すると,緊急手術を要した症例は,肝IIIb型,脾IIIb型以上の高度損傷例であるのに対し,肝IIIa型以下と脾IIIa型以下ではいずれも保存治療が可能であった.したがって,CT所見は,肝・脾鈍的損傷の手術適応の判定にきわめて有用と考えられた., Recent studies have elucidated that the findings of injuries of parenchimatous organs such as liver and spleen by computed tomography (CT) are consistent with those by surgical operation. But it is still unclear whether CT findings can determine operative indication for blunt injuries of liver and spleen. We performed a retrospective study on 35 lesions of blunt injuries of liver and spleen in 33 cases for blunt injuries of liver and spleen at our hospitals to examine whether CT findings can determine the severity of damage and surgical indication for the injuries, and the following results were obtained. 1. Based on CT findings, the presence of injury was confirmed in all cases except for one lesion. 2. Comparison of CT findings and operative or laparoscopic findings in 12 cases undergoing operation or laparoscopy for liver/spleen injury revealed that the findings of each method were almost the same with few exceptions. 3. When liver/spleen injuries were classified according to the Japanese Association for the Surgery of Trauma (JAST) Classification of injury of liver and spleen, cases with emergency operation had severe injury of Type IIIb for the liver and Type IIIb or higher for the spleen, while conservative treatment was possible for injury cases of Type Illa or lower of the liver and spleen. From these results, the JAST Classification of these injuries based upon CT imaging was found to be a suitable method for selecting an appropriate treatment for blund injury of liver and spleen.},
 pages = {815--820},
 title = {JUDGE OF SURGICAL INDICATION FOR BLUNT INJURIES OF LIVER AND SPLEEN BY CT IMAGING},
 volume = {67},
 year = {1997}
}