Department of Diagnostic Radiology, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Center for Cause of Death Investigation Research, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Eur Radiol. 2021 Oct;31(10):7827-7833. doi: 10.1007/s00330-021-07932-8. Epub 2021 Apr 16.
Although laryngohyoid fracture indicates the applied neck pressure and is an important finding in hanging individuals, the reported rate varies widely and its true incidence remains controversial. We used computed tomography (CT) studies to investigate the incidence of laryngohyoid fracture in hanging individuals and identify factors contributing to such fractures.
Considered for inclusion in this study were 107 attempted or successful hanging individuals subjected to CT studies between 2005 and 2019. After excluding 19 whose images were inadequate for evaluation, 88 subjects were included. Body suspension was complete in 20, partial in 49, and unknown in 19; 54 (61.4%) individuals died. Two radiologists performed image analysis and recorded the presence and site of laryngohyoid fractures. Multiple logistic regression analysis was used for factor analysis of laryngohyoid fractures; it included the gender, the age (< or ≧ 40 years), the type of suspension (complete or incomplete), and the outcome (death or survival).
Of the 88 subjects, 35 (39.8%) presented with laryngohyoid fractures on CT images; the superior horn of the thyroid cartilage was fractured in 32 (91.4%) of the 35. Age was the only factor significantly related to laryngohyoid fracture (odds ratio = 2.85, 95% confidence interval = 1.08-7.52).
In hanging individuals, the incidence of laryngohyoid fracture on CT images was 39.8%. The superior horn of the thyroid cartilage was the most frequent fracture site.
• The incidence of laryngohyoid fracture on CT images of hanging individuals was almost 40%; the superior horn of the thyroid cartilage was the most frequent fracture site. • In older hanging individuals, attention must be paid to laryngohyoid fractures on CT images.
尽管喉舌骨骨折表明颈部受压，是上吊者的重要发现，但报告的发生率差异很大，其真实发病率仍存在争议。我们使用计算机断层扫描（CT）研究来调查上吊者中喉舌骨骨折的发生率，并确定导致此类骨折的因素。
本研究纳入了 2005 年至 2019 年间进行 CT 检查的 107 例尝试或成功上吊者。排除 19 例图像评估不充分的患者后，纳入 88 例患者。20 例为完全悬吊，49 例为部分悬吊，19 例悬吊情况未知；54 例（61.4%）患者死亡。两名放射科医生进行图像分析，并记录喉舌骨骨折的存在和部位。多因素逻辑回归分析用于分析喉舌骨骨折的相关因素；包括性别、年龄（<40 岁或≥40 岁）、悬吊类型（完全或不完全）和结局（死亡或存活）。
88 例患者中，35 例（39.8%）CT 图像上存在喉舌骨骨折；35 例中，32 例（91.4%）甲状软骨上角骨折。年龄是与喉舌骨骨折显著相关的唯一因素（比值比=2.85，95%置信区间=1.08-7.52）。
在上吊者中，CT 图像上喉舌骨骨折的发生率为 39.8%。甲状软骨上角是最常见的骨折部位。
• 在 CT 图像上，上吊者中喉舌骨骨折的发生率接近 40%；甲状软骨上角是最常见的骨折部位。• 在老年上吊者中，必须注意 CT 图像上的喉舌骨骨折。
