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亲密伴侣暴力的影像学表现,选自《急诊放射学特辑》。

Imaging of Intimate Partner Violence, From the Special Series on Emergency Radiology.

机构信息

Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115.

Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA.

出版信息

AJR Am J Roentgenol. 2023 Apr;220(4):476-485. doi: 10.2214/AJR.22.27973. Epub 2022 Sep 7.

Abstract

Intimate partner violence (IPV) is a highly prevalent public health issue with multiple adverse health effects. Radiologists are well suited to assessing a patient's likelihood of IPV. Recognition of common IPV injury mechanisms and resulting target and defensive injury patterns on imaging and understanding of differences between patients who have experienced IPV and those who have not with respect to use of imaging will aid radiologists in accurate IPV diagnosis. Target injuries often involve the face and neck as a result of blunt trauma or strangulation; defensive injuries often involve an extremity. Awareness of differences in injury patterns resulting from IPV-related and accidental trauma can aid radiologists in detecting a mismatch between the provided clinical history and imaging findings to support suspicion of IPV. Radiologists should consider all available current and prior imaging in assessing the likelihood of IPV; this process may be aided by machine learning methods. Even if correctly suspecting IPV on the basis of imaging, radiologists face challenges in acting on that suspicion, including appropriately documenting the findings, without compromising the patient's confidentiality and safety. However, through a multidisciplinary approach with appropriate support mechanisms, radiologists may serve as effective frontline physicians for raising suspicion of IPV.

摘要

亲密伴侣暴力(IPV)是一个高度流行的公共卫生问题,对健康有多种不良影响。放射科医生非常适合评估患者遭受 IPV 的可能性。识别常见的 IPV 损伤机制以及影像学上的靶损伤和防御性损伤模式,并了解经历过 IPV 和未经历过 IPV 的患者之间在影像学使用方面的差异,这将有助于放射科医生进行准确的 IPV 诊断。靶损伤通常由于钝性创伤或勒颈而发生在面部和颈部;防御性损伤通常发生在四肢。了解 IPV 相关和意外创伤导致的损伤模式差异,有助于放射科医生检测到提供的临床病史和影像学结果之间的不匹配,以支持对 IPV 的怀疑。放射科医生在评估 IPV 可能性时应考虑所有当前和之前的可用影像学检查;机器学习方法可能有助于该过程。即使根据影像学正确怀疑 IPV,放射科医生在采取行动时也面临挑战,包括在不损害患者保密性和安全性的情况下正确记录检查结果。然而,通过多学科方法和适当的支持机制,放射科医生可以作为提高 IPV 怀疑的一线医生。

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