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[疑似儿童身体虐待的放射学检查]

[Radiological examinations in suspected physical abuse of a child].

作者信息

Valanne Leena, Föhr Anna

出版信息

Duodecim. 2015;131(10):1000-7.

Abstract

Injuries associated with child abuse involve typical imaging findings that should be recognized by every radiologist, because a radiologist may be the first person to raise doubts about abuse. Subdural and subarachnoid hemorrhages in the vicinity of the longitudinal cerebral fissure are characteristic of a brain injury resulting from shaking. Magnetic resonance imaging is the most recommendable method of imaging. At the acute stage, computed tomography is sufficient for the detection of conditions requiring immediate neurosurgical treatment, if magnetic resonance imaging is not possible. Ultrasonography is not sensitive enough for this purpose. Fractures in a child under the age of one year are always suspicious, especially rib fractures. Injuries of the liver, pancreas and intestine are often found in the abdominal region. Contrast-enhanced CT scan is the best investigation in injuries of the lungs and the abdominal region. If a suspicion of physical abuse is raised upon imaging studies, it is important to bring this to the notice of the attending physician and note the issue also in the report.

摘要

与虐待儿童相关的损伤具有典型的影像学表现,每位放射科医生都应认识到这些表现,因为放射科医生可能是第一个对虐待行为产生怀疑的人。大脑纵裂附近的硬膜下和蛛网膜下腔出血是摇晃导致脑损伤的特征性表现。磁共振成像(MRI)是最值得推荐的成像方法。在急性期,如果无法进行磁共振成像,计算机断层扫描(CT)足以检测需要立即进行神经外科治疗的情况。超声检查对此目的不够敏感。一岁以下儿童的骨折总是可疑的,尤其是肋骨骨折。肝脏、胰腺和肠道的损伤常在腹部区域发现。增强CT扫描是肺部和腹部损伤的最佳检查方法。如果在影像学检查中怀疑存在身体虐待,将此事告知主治医生并在报告中注明该问题很重要。

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