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本着交流学习、公益教育的愿望，我们创办了这个公众号。希望各基层医生可以积极踊跃参与我们，共同探讨和学习。公众号内容主要包括：湘雅二医院放射科典型、疑难、罕见病例讨论；英语小讲堂；科研进展和课件荟萃等。 感谢大家的关注，欢迎留言交流。 ● A young adult man who suffered a motor–pedestrian accident.● Click on Annotated Thumbnail to reveal caption● (A,B) Contrast-enhanced computed tomography (CT) of the chest shows abnormal low density occupying the posterior mediastinum, producing mass effect on the aorta and heart, which are being displaced anteriorly (white arrows). Linear areas of low density are also seen involving the vertebral bodies (black arrows).● （A，B）肺部增强CT显示后纵隔异常低密度占位，主动脉和心脏出现肿物压迫，向前移位（白色箭头）。低密度的线状区域也累及椎体（黑色箭头）。● (A,B) Contrast-enhanced computed tomography (CT) of the chest shows abnormal low density occupying the posterior mediastinum, producing mass effect on the aorta and heart, which are being displaced anteriorly (white arrows). Linear areas of low density are also seen involving the vertebral bodies (black arrows).● （A，B）肺部增强CT显示后纵隔异常低密度占位，主动脉和心脏出现肿物压迫，向前移位（白色箭头）。低密度的线状区域也累及椎体（黑色箭头）。● Posterior mediastinal hematoma: Posterior mediastinal and paravertebral hematomas in trauma patients are commonly seen associated with vertebral body fractures.● 后纵隔血肿：后纵隔及椎旁血肿常见创伤患者椎体骨折相关。 ● Traumatic aortic injury: Mediastinal hematomas resulting from traumatic aortic injury are typically seen in intimate contact with the aorta.● 创伤性主动脉损伤：外伤性主动脉损伤引起的纵隔血肿通常与主动脉密切接触。 ● Esophageal injury: Esophageal injury from blunt thoracic trauma is uncommon but may occur. Imaging presentation may include periesophageal or intramural hematoma, mediastinal fluid, and pneumomediastinum.● 食管损伤：钝性胸外伤引起的食管损伤不常见，但可能发生。影像表现包括食管周围或壁内血肿、纵隔及纵隔气肿的流体。● Sternal and vertebral fractures are common findings in patients with polytrauma and often present with mediastinal hematoma.● 胸骨和脊椎骨折多发伤患者，常表现为纵隔血肿的常见表现。● Fractures of the thoracic spine occur in 3% of patients with blunt trauma. ● A large number of these patients present with associated spinal cord injury.● Two-thirds of patients with fractures of the lower cervical or thoracic region present with mediastinal hematoma on chest radiographs.● 三分之二的下颈椎或胸段骨折患者在胸片上出现纵隔血肿。 ● Two-thirds of patients with fractures of the lower cervical or thoracic region present with mediastinal hematoma on chest radiographs.● 三分之二的下颈椎或胸段骨折患者在胸片上出现纵隔血肿。 ● Posterior mediastinal hematoma in contact with the anterior aspect of the vertebral bodies is suggestive of a spinal fracture.● In motor vehicle accidents, the most commonly affected levels are the T11–L2 vertebral bodies (60–70%).● 在机动车事故中，最常见的发病水平是T11–L2椎体（60–70%）。 ● Anterior compression fracture is the most common type of fracture seen in the thoracic spine.● Flexion-distraction fracture of the thoracolumbar spine (Chance-type fracture) is commonly associated with intra-abdominal injuries (40%).● 胸腰椎屈曲牵张骨折（机会型骨折）常伴有腹内损伤（40%）。● Only 50% of these thoracic spine fractures are identified on the initial chest radiographs.● Multidetector CT with multiplanar reconstruction has much higher sensitivity and specificity (> 98%) for the detection of spinal fractures and is the imaging modality of choice for patients with polytrauma.● 多层螺旋CT多平面重建具有更高的敏感性和特异性（> 98%）脊柱骨折的检测和影像学检查的首选例多发伤。● Sagittal and coronal re-formations are extremely useful in the detection and evaluation of chest wall fractures in trauma patients.● 矢状面和冠状位重建在创伤患者胸壁骨折的检测和评估中非常有用。 ● No Other Imaging Findings● Isolated mediastinal hematomas confined to the anterior or posterior mediastinum, and not in contact with the aorta, are rarely from aortic injury and likely result from chest wall fracture. The mediastinal hematoma associated with traumatic aortic injury surrounds the aortic arch or proximal descending aorta.● 局限于前纵隔或后纵隔的孤立性纵隔血肿，很少与主动脉接触，很少由主动脉损伤引起，也可能由胸壁骨折引起。伴有外伤性主动脉损伤的纵隔血肿环绕主动脉弓或近降主动脉。 ● Pitfalls in the detection of posterior mediastinal hematomas in trauma patients may result from the presence of paraspinal atelectasis and pleural fluid medially located between the lung and mediastinum.● 在后纵隔血肿外伤患者，可能导致椎旁肺不张的存在和胸腔积液位于内侧的肺和纵隔之间.● Bernstein MP, Mirvis SE, Shanmuganathan K. Chance-type fractures of the thoracolumbar spine: imaging analysis in 53 patients. AJR Am J Roentgenol. 2006;187(4):859-868.
● Collins J. Chest wall trauma. J Thorac Imaging. 2000;15(2):112-119.Earls JP, Kenney JP, Patel NH. A mediastinal hematoma after a fall. AJR Am J Roentgenol. 1997;169(3):659.● Kuhlman JE, Pozniak MA, Collins J, Knisely BL. Radiographic and CT findings of blunt chest trauma: aortic injuries and looking beyond them. Radiographics. 1998;18(5):1085-1106, discussion 1107–1108, quiz 1.
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