CT测量在眶内壁骨折损伤程度鉴定中的应用  

Application of CT Measurement in the Identifications of Injury Degree in Medial Orbital Fracture

作　　者：李卓 屈胜秋 周智露 陈捷敏 王萌 汪茂文 夏文涛 LI Zhuo;QU Shengqiu;ZHOU Zhilu;CHEN Jiemin;WANG Meng;WANG Maowen;XIA Wentao(Shanghai Key Laboratory of Forensic Medicine,Shanghai Forensic Service Platform,Key Laboratory of Forensic Science,Ministry of Justice,Academy of Forensic Science,Shanghai 200063,China;West China School of Basic Medical Sciences&Forensic Medicine,Sichuan University,Chengdu 610041,China;Department of Forensic Medicine,Guizhou Medical University,Guiyang 550009,China)

机构地区：[1]司法鉴定科学研究院上海市法医学重点实验室上海市司法鉴定专业技术服务平台司法部司法鉴定重点实验室,上海200063 [2]四川大学华西基础医学与法医学院,四川成都610041 [3]贵州医科大学法医学系,贵州贵阳550009

出　　处：《中国司法鉴定》2022年第1期79-84,共6页Chinese Journal of Forensic Sciences

基　　金：上海市法医学重点实验室资助项目(21DZ2270800);上海市司法鉴定专业技术服务平台资助项目(19DZ2292700)。

摘　　要：目的利用CT测量眶内壁骨折案件中伤者眶容积扩大率及眶内壁骨质缺损面积,探讨两种CT测量值用于评估眶内壁骨折范围的可行性。方法选取20例无眼眶骨折案件作为对照组,使用CT测量双侧眶容积,并比较两例是否存在差异。选取本院2018—2020年间受理的眶内壁骨折案件39例作为实验组,并根据鉴定意见分为轻伤组与轻微伤组。分别测量眶容积扩大率及眶内壁骨质缺损面积,分析对照组及实验组双侧眶容积的差异,比较实验组健侧眶容积与对照组双侧眶容积的差异,比较轻伤组与轻微伤组间眶容积扩大率及眶内壁骨质缺损面积的差异。按照眶容积扩大率是否大于8%、眶内壁骨质缺损面积是否大于2 cm2,对两个实验组数据进行分类统计、分析。结果对照组双侧眶容积的差异无统计学意义(P>0.05)。实验组健侧眶容积与对照组双侧眶容积的差异无统计学意义(P>0.05)。两个实验组内双侧眶容积的差异均具有统计学意义(P<0.05)。两个实验组间眶容积扩大率及眶内壁骨质缺损面积的差异均具有统计学意义(P<0.05)。当眶容积扩大率≥8%且眶内壁骨质缺损面积≥2 cm2时,案件评定为轻伤的比例最高(86.67%)。结论利用眶容积扩大率及眶内壁骨质缺损面积来评估眶内壁骨折范围具有可行性。Objective The orbital volume expansion rate and the bone defect area of the orbital wall were measured by CT in the injured patients in the case of orbital wall fracture,and the feasibility of the two CT measurements in evaluating the orbital wall fracture range was discussed.Methods Twenty cases without orbital fracture were selected as the control group,CT was used to measure the bilateral orbital volume,and the difference of which was compared.Thirty-nine cases of unilateral medial wall fracture in our academy from 2018 to 2020 were selected and divided into experimental groups of minor and slight injury.The expanded rate of orbital volume and the bone defect area of medial orbital wall were measured respectively.The difference of bilateral orbital volume in the experimental groups was analyzed.The difference between the uninjured orbit in the experimental groups and the control group,and the difference of the expanded rate of orbital volume and the bone defect area between two experimental groups were analyzed separately.According to whether the expanded rate of orbital volume is greater than 8%and the bone defect area is greater than 2 cm2,the data of these two experimental groups were classified and analyzed.Results There was no significant difference between the bilateral orbital volumes in control group(P>0.05),and also no significant difference between the uninjured orbit in the experimental groups and the control group(P>0.05).The difference of bilateral orbital volume in the two experimental groups was statistically significant(P<0.05).There were significant differences in the expanded rate of orbital volume and the bone defect area between the two experimental groups(P<0.05).When the expanded rate of orbital volume was greater than or equal to 8%and the bone defect area was greater than or equal to 2 cm2,the proportion of minor injury was the highest(86.67%).Conclusion.It is feasible to evaluate the severity of orbital fracture by measuring the expanded rate of orbital volume and the bone defect area.

关 键 词：法医学 眶内壁骨折 眼眶容积 CT测量 

分 类 号：D919[医药卫生—法医学]