高分辨率64层螺旋CT在鼻骨骨折法医鉴定中的应用价值  

The value of high-resolution 64-slice spiral CT in the forensic identification of nasal bone fractures

作　　者：李善杰[1] 崔俊瑞[1] 许伟[1] 陈维亮[1] 

机构地区：[1]中国人民解放军第371中心医院影像中心,河南新乡453000

出　　处：《实用医学影像杂志》2011年第6期374-376,共3页Journal of Practical Medical Imaging

摘　　要：目的评价高分辨率64层螺旋CT(HR-MSCT)扫描在鼻骨骨折法医鉴定中的应用价值。方法收集自我院200例(包括外伤性180例和非外伤性20例)鼻骨骨折患者均经颅面部HR-MSCT扫描。其中,180例外伤性鼻骨骨折患者依据其CT表现分为3种类型:Ⅰ型为单侧或双侧鼻骨骨折,断端无明显错位或成角,Ⅱ型为单侧或双侧鼻骨骨折,伴有明显的断端错位(大于1/2)或明显的成角(大于等于45°),Ⅲ型为粉碎性骨折。结果在200例患者中,外伤性与非外伤性鼻骨骨折患者分别见于180例和20例。研究证实,在180例外伤性鼻骨骨折患者中有Ⅰ型41例,Ⅱ型35例以及Ⅲ型104例。结论 HR-MSCT扫描可清晰显示鼻骨骨折的部位、范围、积液,并能对外伤性骨折准确分型,为司法鉴定及临床诊治提供可靠依据。Objective To assess the applied value of high resolution 64-slice spiral CT（HR-MSCT） scans in the forensic identification of nasal bone fractures.Methods Two-hundred patients with nasal bone fracture whose cause comprised trauma（n=180） and non-trauma（n=20） were collected from our hospital.All patients underwent HR-MSCT scans of the craniofacial part,of whom,180 patients with traumatic fracture were classified into three types according to their CT appearances： type Ⅰ,unilateral or bilateral fractures without obvious displacement and angulation of the broken ends,type Ⅱ,unilateral or bilateral fractures associated with obvious displacement（more that 1/2） or angular deformity（more than or equal to 45°） of the broken ends,and type Ⅲ,comminuted fracture.Results Among 200 patients with nasal bone fracture,traumatic and non-traumatic fracture were found in 180 and 20 cases,respectively.The study demonstrated that there were 41 type Ⅰ,35 type Ⅱ,and 104 type Ⅲ in the group patients.Conclusion HR-MSCT scan could clearly visualize the site,extent and exudation of nasal bone fractures and could accurately classify for them so that it can provide the reliable evidence for forensic identification of traumatic nasal bone fracture as well as diagnosis and treatment.

关 键 词：鼻骨骨折 外伤性或非外伤性 体层摄影术 X线计算机 CT分型 司法鉴定 

分 类 号：D919.4[医药卫生—法医学]