Department of Forensic Medicine, Netherlands Forensic Institute, The Hague, The Netherlands; Department of Radiology, Academic Medical Center/Emma Children's Hospital, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
Eur J Radiol. 2014 Mar;83(3):584-8. doi: 10.1016/j.ejrad.2013.11.015. Epub 2013 Dec 4.
To determine whether imaging findings can be used to differentiate between impact and non-impact head trauma in a group of fatal and non-fatal abusive head trauma (AHT) victims.
We included all AHT cases in the Netherlands in the period 2005-2012 for which a forensic report was written for a court of law, and for which imaging was available for reassessment. Neuroradiological and musculoskeletal findings were scored by an experienced paediatric radiologist.
We identified 124 AHT cases; data for 104 cases (84%) were available for radiological reassessment. The AHT victims with a skull fracture had fewer hypoxic ischaemic injuries than AHT victims without a skull fracture (p=0.03), but the relative difference was small (33% vs. 57%). There were no significant differences in neuroradiological and musculoskeletal findings between impact and non-impact head trauma cases if the distinction between impact and non-impact head trauma was based on visible head injuries, as determined by clinical examination, as well as on the presence of skull fractures.
Neuroradiological and skeletal findings cannot discriminate between impact and non-impact head trauma in abusive head trauma victims.
确定影像学表现是否可用于区分一组致命和非致命虐待性头部创伤（AHT）患者中的撞击性和非撞击性头部创伤。
我们纳入了 2005 年至 2012 年期间荷兰所有因法庭需要法医报告且影像学资料可用于重新评估的 AHT 病例。神经放射学和肌肉骨骼表现由经验丰富的儿科放射科医生进行评分。
我们确定了 124 例 AHT 病例；104 例（84%）的 AHT 病例有影像学重新评估的数据。与无颅骨骨折的 AHT 受害者相比，有颅骨骨折的 AHT 受害者的缺氧缺血性损伤较少（p=0.03），但相对差异较小（33%对 57%）。如果根据临床检查确定的可见头部损伤以及颅骨骨折来区分撞击性和非撞击性头部创伤，那么在撞击性和非撞击性头部创伤病例之间，神经放射学和肌肉骨骼表现没有显著差异。
在虐待性头部创伤受害者中，神经影像学和骨骼表现不能区分撞击性和非撞击性头部创伤。
