GIÁ TRỊ CỦA CẮT LỚP VI TÍNH TRONG CHẨN ĐOÁN VÀ PHÂN ĐỘ CHẤN THƯƠNG TỤY

Abstract

Objective: To evaluate the role of computed tomography (CT) in the diagnosis and grading of pancreatic trauma. Materials and Methods: A cross-sectional descriptive study was conducted on 70 patients aged ≥18 years with CT-confirmed pancreatic trauma, treated at Viet Duc University Hospital from January 2022 to July 2025. Clinical, laboratory, and CT imaging data were collected and compared with surgical findings when available. Results: Males accounted for 78.6% of cases, with a mean age of 37.7 ± 15.69 years. Road traffic accidents were the most common cause (84.3%). The predominant symptom was abdominal pain (100%), with elevated serum amylase in 88.1% of cases. CT findings included: ascites (100%), peripancreatic fluid (97.1%), parenchymal contusion (91.4%), parenchymal laceration (85.7%), intraparenchymal hematoma (20%), and suspected pancreatic duct injury (52.9%). Among 46 patients who underwent surgery, 40 (87.0%) were confirmed to have pancreatic injury. Diagnostic performance of CT signs compared to surgery was as follows: peripancreatic fluid (sensitivity 97.5%, specificity 16.7%), pancreatic contusion (97.4%; 25%), intraparenchymal hematoma (85.7%; 100%), pancreatic laceration (97.1%; 72.7%), transection (52%; 95.2%), suspected ductal injury (93.8%; 64.3%). CT accurately identified the injury location in 100% of cases (head, neck, body, and tail of the pancreas). Grading comparison revealed that CT tended to underestimate the severity, particularly in grade I and III injuries; higher grades (IV, V) were generally consistent with surgical findings. Conclusion: CT is a highly valuable imaging modality for early detection, precise localization, and grading of pancreatic trauma, particularly in identifying pancreatic duct injuries, thereby supporting treatment planning and surgical decision-making.