163处肋骨骨折的影像学分析

目的：探讨影像学检查方法在不同区段肋骨骨折法医学鉴定中的应用。方法回顾性分析56例被鉴定人共计163处肋骨骨折的骨折部位、影像学检查次数及其首次检出的影像学技术等资料。结果在损伤后早期（≤14 d）的检出率为65.6%。 X线对肋骨前段骨折的首次检出率76.2%，两次内检出率90.5%；CT首次检出率66.7%，两次内检出率80.0%。 X线对肋骨腋段骨折的首次检出率仅27.6%，两次内检出率58.6%；CT首次检出率54.3%，两次内检出率80.4%。X线对肋骨背段骨折的首次检出率63.6%，两次内检出率81.8%；CT首次检出率50.0%，两次内检出率70.0%。结论在肋骨骨折的鉴定中，应注意影像学检查的随访，综合运用不同技术手段，尤其在疑有肋骨腋段骨折的案例中，单纯X线摄片可能造成漏检，建议选择CT扫描。

Analysis of 163 Rib Fractures by Imaging Examination

Objective To explore the applications of im aging exam ination on rib fracture sites in forensic identification. Methods Features including the sites, num bers of the processed im aging exam ination and the first radiological technology at diagnosis in 56 cases of rib fractures from 163 injuries were retro-spectively analyzed. Results The detection rate of the rib fractures within 14 days was 65.6% . The ini-tial detection rate of anterior rib fracture proceeded by X-ray was 76.2%, then 90.5% detected at a sec-ond tim e X-ray, while the detection rate of CTwas 66.7% and 80.0%, respectively. The initial detec-tion rate of rib fracture in axillary section proceeded by X-ray was 27.6%, then 58.6% detected at a second tim e X-ray, while the detection rate of CTwas 54.3% and 80.4%, respectively. The initial de-tection rate of posterior rib fracture proceeded by X-ray was 63.6%, then 81.8% detected at a second tim e X-ray, while the detection rate of CTwas 50.0% and 70.0%, respectively. Conclusion It is im por-tant to pay attention to the use of com bined im aging exam inations and the follow-up results. In the cas-es of suspicious for rib fracture in axillary section, CTexam ination is suggested in such false X-ray negative cases.