法医学杂志

法医学杂志 ›› 2005, Vol. 21 ›› Issue (2): 84-85+8.

• 论文 • 上一篇    下一篇

CT在肋骨骨折认定中的价值及骨折的力学分析

徐雷鸣,谢兴夫   

  1. 浙江大学医学院附属二院放射科,浙江法会司法鉴定所 浙江杭州310009 ,浙江杭州310007
  • 发布日期:2005-04-25 出版日期:2005-04-28

CT Rendering and Mechanical Analysis for Rib Fracture Inextricable on X-ray Chest Film in Legal Medical Practice

XU LEI-MING, XIE XING-FU (DEPATMENT OF RADIOLOGY, 2ND HOSPITAL ATTACHED TO ZHEJIANG UNIVERSITY MEDICAL SCHOOL, HANGZHOU 310009,CHINA)   

  • Online:2005-04-25 Published:2005-04-28

被引次数

44

摘要： 目的探讨在法医学鉴定中普通X线片难以确定的肋骨骨折,以CT技术加以显示的方法,并阐明肋骨骨折的力学原理。方法对17例普通X线技术显示困难的肋骨骨折行CT扫描,采用薄层平滑和高分辨率重建、表面遮盖法和多平面重建观察,确定肋骨骨折的部位、数量、形态、移位和骨痂形成情况等信息。结果17例X线平片难以确定的骨折,通过上述CT扫描和后处理重建技术,均得到满意的结果。通过骨折力学分析和影像观察,将间接暴力导致肋骨骨折的力矩分成垂直和旋转两类,从而提出垂直型和旋转型肋骨骨折的分类。结论对普通X线平片难以确定的肋骨骨折,建议采用薄层CT扫描,沿肋骨长轴多平面重建观察,结合肋骨骨折的力学原理,有助于避免将急性旋转型肋骨骨折误诊为陈旧骨折。

关键词: 肋骨, 骨折, X线, CT, 力学

Abstract: Objective To explore an approach of CT rendering and mechanical analysis for rib fracture that was inextricable on X-ray film in legal medical practice. Methods 17 cases with rib fracture undetermined on X-ray chest film in legal medical practice underwent CT scans. The thin slices (0.75 mm or 1mm) of images were reconstructed with smooth and sharp kernel.The multiplanar reformatted images along rib and surface shaded display were obtained to investigate rib fracture. Results All rib fractures were accurately displayed by CT scan and MPR images along rib. The torque that caused rib fracture was divided presumably into vertical and rotary types. The two kinds of rib fracture, composed of vertical and rotary type, were proposed. Conclusion CT scan with thin slice and MPR images can definitely reveal the rib fracture unresolved on X-ray film in legal medical practice. The proposition of two kinds of torque will be help avoid misunderstanding acute rotary type of rib fracture as old healed one.

Key words: rib, fracture, X-ray, computed tomography, mechanics