Department of Forensic Medicine, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450000, China.
Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China.
Fa Yi Xue Za Zhi. 2022 Apr 25;38(2):217-222. doi: 10.12116/j.issn.1004-5619.2021.410809.
To study the correlation between CT imaging features of acceleration and deceleration brain injury and injury degree.
A total of 299 cases with acceleration and deceleration brain injury were collected and divided into acceleration brain injury group and deceleration brain injury group according to the injury mechanism. Subarachnoid hemorrhage (SAH) and Glasgow coma scale (GCS), combined with skull fracture, epidural hematoma (EDH), subdural hematoma (SDH) and brain contusion on the same and opposite sides of the stress point were selected as the screening indexes. test was used for primary screening, and binary logistic regression analysis was used for secondary screening. The indexes with the strongest correlation in acceleration and deceleration injury mechanism were selected.
test showed that skull fracture and EDH on the same side of the stress point; EDH, SDH and brain contusion on the opposite of the stress point; SAH, GCS were correlated with acceleration and deceleration injury (<0.05). According to binary logistic regression analysis, the odds ratio (OR) of EDH on the same side of the stress point was 2.697, the OR of brain contusion on the opposite of the stress point was 0.043 and the OR of GCS was 0.238, suggesting there was statistically significant (<0.05).
EDH on the same side of the stress point, brain contusion on the opposite of the stress point and GCS can be used as key indicators to distinguish acceleration and deceleration injury mechanism. In addition, skull fracture on the same side of the stress point, EDH and SDH on the opposite of the stress point and SAH were relatively weak indicators in distinguishing acceleration and deceleration injury mechanism.
研究加速性和减速性脑损伤的 CT 影像学特征与损伤程度的相关性。
收集 299 例加速性和减速性脑损伤患者，根据损伤机制分为加速性脑损伤组和减速性脑损伤组。选择蛛网膜下腔出血（SAH）和格拉斯哥昏迷评分（GCS），结合颅骨骨折、同侧额部硬膜外血肿（EDH）、同侧和对侧硬膜下血肿（SDH）和脑挫裂伤作为筛选指标。采用卡方检验进行初步筛选，采用二项逻辑回归分析进行二次筛选。选择与加速和减速损伤机制相关性最强的指标。
卡方检验显示，颅骨骨折和同侧额部 EDH；同侧和对侧 EDH、SDH 和脑挫裂伤；SAH、GCS 与加速和减速损伤相关（<0.05）。根据二项逻辑回归分析，同侧 EDH 的优势比（OR）为 2.697，对侧脑挫裂伤的 OR 为 0.043，GCS 的 OR 为 0.238，差异有统计学意义（<0.05）。
同侧额部 EDH、对侧脑挫裂伤和 GCS 可作为区分加速性和减速性损伤机制的关键指标。此外，同侧额部颅骨骨折、对侧额部 EDH 和 SDH 以及 SAH 是区分加速性和减速性损伤机制的相对较弱指标。
