多层螺旋CT、普通CT和X线在骨折法医学鉴定中的应用

目的比较多层螺旋CT（MSCT）、普通CT与X线3种检查法,评价它们在骨折法医鉴定中的应用价值。方法对366例受检者（已接受其他影像学检查）行MSCT薄层扫描并行SSD,透明化X线模拟投影和MPR处理。统计分析MSCT、CT常规与X线检查在各部位骨折中的诊断正确率和漏、误诊率并行χ2检验。结果鼻骨、肋骨、四肢及关节、眶骨、颅骨骨折MSCT诊断正确率明显高于普通CT或X线（P〈0.01）。MSCT与普通CT对脊柱骨折的诊断正确率无统计学差异（P〉0.05）。MSCT、普通CT与X线的总体诊断正确率分别为99.45%、70.27%和59.17%。常规CT、X线与MSCT诊断结果间存在显著统计学差异（P〈0.001）。结论MSCT对骨折的显示更准确,可作为法医鉴定的重要辅助检查手段。

Role of MSCT, routing X-ray and CT in forensic identification of fractures

Objective To compare MSCT with routing X-ray, CT and appraise their applications to fractures in forensic identification. Methods366 cases which had got routing X-ray or CT examination were examined by thin slice scanning with MSCT and all of the data were processed with MPR, see-through and SSD method. Accurate diagnosis rate and misdiagnosis & underdiagnosis rate were calculated and analyzed by Chi-square test. ResultsThe accurate diagnosis rates of MSCT in nasal fracture, rib fracture, limb or joint fracture, orbital fracture and cranial fracture were higher than that of X-ray or routing CT (P<0.01). There was no statistical difference in accurate diagnosis rate between MSCT and routing CT in spinal fracture (P>0.05). The total accurate diagnosis rates of X-ray, routing CT and MSCT were 59.17%, 70.27% and 99.45%, respectively. There were significant differences (P<0.001) in accurate diagnosis rate between routing CT, X-ray and MSCT. ConclusionMSCT scan is reliable for fracture identification. It will perform the important role in forensic medicine.