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目的探讨急诊颅脑外伤的CT误诊漏诊原因,以提高诊断水平。方法回顾性分析本院2008年1月夜间急诊颅脑外伤CT检查368例。所有病例均采用螺旋CT扫描,由上级医师利用科内PACS于次日读片复核,具体分析误诊漏诊原因。结果发现误诊3例,各类漏诊14例。分析误诊漏诊原因主要为①读片医师经验不足。②CT室技师检查操作不当。③病人烦躁不配合,造成图像失真。④损伤早期征象细微或不典型。结论为了提高急诊颅脑外伤的诊断水平,影像科必须训练技师使之检查操作更为快捷规范,提高医师对各种颅脑外伤及正常解剖的影像表现的认识,密切结合临床症状及体征确立诊断,当临床表现严重而CT征象不典型时,短期内及时复查,薄层扫描结合重建技术有利于诊断的确立。
Objective To explore the causes of misdiagnosis and missed diagnosis of emergency craniocerebral trauma in order to improve the diagnostic level. Methods A retrospective analysis of our hospital in January 2008 night emergency traumatic brain injury CT examination of 368 cases. All cases were using spiral CT scan, by the superior physicians using PACS in the next day reading review, the specific analysis of misdiagnosis reasons. The results found that misdiagnosis in 3 cases, all kinds of missed diagnosis in 14 cases. Analysis misdiagnosis mainly due to ① missed reading physician lack of experience. ② CT room technician check improper operation. ③ patient irritability does not match, resulting in image distortion. ④ early signs of injury subtle or atypical. Conclusion In order to improve the diagnosis of emergency craniocerebral trauma, the imaging department must train the technicians to make the operation more quick and standardized, enhance the physicians’ understanding of various craniocerebral trauma and imaging findings of normal anatomy, and establish the diagnosis according to the clinical symptoms and signs closely , When the clinical manifestations of severe and CT signs of atypical, short-term timely review, combined with reconstruction of thin-layer scanning technology is conducive to the establishment of diagnosis.