CHN骨龄在司法鉴定中的应用价值

目的探讨CHN(中国人手腕骨发育标准CHN法)骨龄在司法鉴定中的应用价值,分析影响其准确性的因素及相关问题。方法对522例年龄鉴定者,均选用不同曝光值拍摄两张左手腕部正位X线片,并加照两次斜位片。使用CHN法测评骨龄。结果522例中男性489例,女性33例。男性达CHN骨龄最高值18.4岁者129例,余平均骨龄16.5岁。女性达CHN骨龄最高值17.3岁者14例,余平均骨龄15.7岁。CHN骨龄在16.0岁以上者共388例,占约74.3%。本组资料显示多种因素影响骨龄鉴定的准确性,其中以骨龄片位置及角度的变化等影响最大。结论如能获得高质量的X线片、并能熟练使用CHN法、注意利用位置和角度的变化正确判定骨骺分级,CHN骨龄基本可满足活体年龄鉴定的需要。

Application value of CHN bone age in judicial identification

Objective Probe application value of CHN(the standards of skeletal maturity of hand and wrist for Chinese-CHN method)bone age in judicial identification,and analyze factors and related problems which influence its accuracy.Methods 522 patients participated in judicial identification of living age estimation.Two posteroanterior radiographs for the left wrist were shot with respective exposure value for all patients.And two oblique radiographs were added.Bone ages were estimated according to CHN method.Result Among 522 cases were 489 males and 33 females.Bone ages of 129 males reached to tiptop of CHN-18.4 and average bone age of other male patients is 16.5.Bone ages of 14 females reached to tiptop of CHN-17.3 and average bone age of other female patients is 15.7.Among 522 cases there were 388 patients with their CHN bone ages above 16.0,about 74.3%.The group of data indicates that multiple factors can influence accuracy of bone age estimation.Among them change of radiograph position and angle influenced estimation accuracy most.Conclusion If radiographs of high quality can be acquired,CHN method can be proficiently used,and radiologists can pay attention to the effect on estimation accuracy of epiphysis classification by change of radiograph position and angle,then CHN bone age can mostly meet requirements of living age estimation.