4种影像学检查方法应用于肩关节损伤法医学鉴定的比较

Comparison of Four Imaging Examinations of Shoulder Joint Injury in Forensic Expertise

目的评价X线、CT、MRI及CT气-碘双对比造影4种方法在肩关节损伤法医学鉴定中的应用价值。方法通过对肩关节损伤患者行X线摄片、CT扫描、MRI成像与CT气-碘双对比造影检查,观察、分析4种方法所得的影像学资料。结果 X线摄片对骨折的诊断率为52.8%,对软组织损伤的诊断率为0%;CT对骨折的诊断率为72.0%,对软组织损伤的诊断率为32.9%;MRI对骨折的诊断率为63.2%,对软组织损伤的诊断率为82.5%;CT气-碘双对比造影对软组织损伤的诊断率为100%。结论 X线摄片可作为肩关节损伤的筛选检查,CT对骨折的诊断率高,MRI对软组织损伤的诊断率高,CT气-碘双对比造影可准确反映肩关节软组织损伤的严重性。联合运用上述方法,可为肩关节损伤法医学鉴定提供重要的影像学信息。

Objective To compare the value of four imaging examinations,including the X-ray,CT,MRI and gas-iodine double contrast CT analyses,in the forensic expertise of shoulder joint injury.Methods Imaging data of shoulder joint injury,by the X-ray,CT,MRI and gas-iodine double contrast CT were retrieved and analyzed.Results The correct diagnosis rates of fracture and soft tissue injury by X-ray,CT and MRI were 52.8%,72.0% and 63.2%,as well as 0.0%,32.9% and 82.5%,respectively.The correct diagnosis rate of soft tissue injury by gas-iodine double contrast CT was 100%.Conclusion X-ray is a useful screening method,CT is better for diagnosis of fracture,and MRI is fit for diagnosis of soft tissue injury.Gas-iodine double contrast CT can reflect not only the soft tissue injury but also its severity.Thus,combined application of X-ray,CT,MRI and gas-iodine double contrast CT can provide important imaging information for forensic expertise in shoulder joint injury.