多层螺旋CT后处理技术在创伤专科医院鼻骨骨折法医鉴定中的应用价值

The application value of multislice CT post-processing technique in forensic identification in trauma specialist hospital

目的评价分析多层螺旋CT检查在创伤专科医院鼻骨骨折法医鉴定中的诊断及应用价值。方法采用回顾性分析法收集2005年1月-2015年12月10年间北京市红十字急诊抢救中心诊治鉴定的3020例鼻骨骨折病例，所有病例均为外伤性鼻骨骨折，均经颅面部CT扫描。结果在3020例外伤性鼻骨骨折患者中，Ⅰ型骨折245例（8．11％），Ⅱ型骨折964例（31．92％），Ⅲ型骨折1449例（47．99％），Ⅳ型骨折362例（11．98％）；法医鉴定轻伤二级1362例（45．10％），居首位，重伤二级148例（4．90％），最少；在临床应用中，应根据患者不同病情采用个体化CT后处理技术，可提高鼻骨骨折诊断的准确性，降低临床漏诊率。结论采用多层螺旋CT扫描后处理技术能够清晰显示鼻骨骨折及其周围特殊结构，能准确对骨折进行分型与鉴别，为司法鉴定及临床诊治提供了可靠依据。

Objective To analyze application value of multislice CT in forensic identification of nasal bone f,actures in trauma specialist hospital. Methods 3020 cases of nasal bone fracture cases admitted in our hospital from 2005 to 2015 were recruited.All cases were traumatic nasal bone fracture accepted transeranial facial CT scans. Results In 3020 patients with traumatic nasal bone fracture, I fractures in 245 cases （8.11%）, Ⅱ fractures in 964 cases （31.92%）, Ⅲ fractures in 1449 cases （47.99%）, Ⅳ type fractures in 362 cases （11.98%）; Forensie minor level 2 1362 cases （45.10%）, in the first place, seriously level 2 148 cases （4.90%）, minimum; Different patient individual CT post-processing technique can improve the accuracy of the diagnosis of nasal bone fraclure. Conclusion Muhislice CT post-processing technique can clearly show the nasal bone fracture and the special structure, help accurate fracture classification and identification, provide a reliable basis for judicial authentication and benefit a lot to clinical diagnosis and treatment.