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[虐待儿童的警示信号:儿科放射学与法医学方面]

[Red flags for child abuse : Pediatric radiological and forensic aspects].

作者信息

Hahnemann Maria L, Wittschieber Daniel, Mentzel Hans-Joachim

机构信息

Klinik für Diagnostische und Interventionelle Neuroradiologie und Kinderneuroradiologie, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.

Institut für Rechtsmedizin, Universitätsklinikum Bonn, Stiftsplatz 12, 53111, Bonn, Deutschland.

出版信息

Radiologie (Heidelb). 2024 Nov;64(11):868-874. doi: 10.1007/s00117-024-01360-7. Epub 2024 Aug 19.

DOI:10.1007/s00117-024-01360-7
PMID:39158727
Abstract

CLINICAL ISSUE

The diagnostics of physical child abuse are usually performed by a multidisciplinary team and frequently represent a clinical challenge. Radiological expertise is particularly important for the recognition of abusive injuries to the skeletal system and the central nervous system. The aim of the article is to give an overview of red flags of child abuse in radiological imaging.

IMAGING METHODS

For the diagnostics of child abuse, conventional projection radiography of the skeletal system as well as computed tomography (CT) and magnetic resonance imaging (MRI) of the head are especially relevant. There is insufficient evidence with respect to sonography.

CONCLUSION

Radiological imaging plays a key role for recognizing physical child abuse. Radiological red flags of child abuse can be crucial for making the diagnosis.

摘要

临床问题

身体虐待儿童的诊断通常由多学科团队进行,且常常是一项临床挑战。放射学专业知识对于识别骨骼系统和中枢神经系统的虐待性损伤尤为重要。本文旨在概述放射影像学中儿童虐待的警示信号。

成像方法

对于儿童虐待的诊断,骨骼系统的传统投影放射摄影以及头部的计算机断层扫描(CT)和磁共振成像(MRI)尤为相关。关于超声检查的证据不足。

结论

放射影像学在识别身体虐待儿童方面起着关键作用。儿童虐待的放射学警示信号对于做出诊断可能至关重要。

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本文引用的文献

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Benign enlargement of the subarachnoid spaces and subdural collections-when to evaluate for abuse.蛛网膜下腔和硬脑膜下间隙的良性增大——何时需要评估滥用。
Pediatr Radiol. 2023 Apr;53(4):752-767. doi: 10.1007/s00247-023-05611-y. Epub 2023 Mar 1.
2
Characterization of subdural collections in initial neuroimaging of abusive head trauma: Implications for forensic age diagnostics and clinical decision-making.虐待性头部创伤初始神经影像学中硬膜下积液的特征:对法医年龄诊断和临床决策的影响。
Eur J Radiol. 2023 Feb;159:110652. doi: 10.1016/j.ejrad.2022.110652. Epub 2022 Dec 15.
3
Understanding Bilateral Skull Fractures in Infancy: A Retrospective Multicenter Case Review.
婴幼儿双侧颅骨骨折的认识:一项回顾性多中心病例分析
Pediatr Emerg Care. 2023 May 1;39(5):329-334. doi: 10.1097/PEC.0000000000002704. Epub 2022 Apr 13.
4
Incidence, pattern and mechanisms of injuries and fractures in children under two years of age.两岁以下儿童损伤和骨折的发生率、类型和机制。
BMC Musculoskelet Disord. 2021 Jun 18;22(1):555. doi: 10.1186/s12891-021-04420-4.
5
Cranial Suture Evaluation in Pediatric Head Trauma: Importance in Differentiating Abusive From Accidental Injury.小儿头部创伤时颅缝的评估:有助于区分虐待性损伤与非外伤性损伤。
Pediatr Emerg Care. 2022 Feb 1;38(2):e703-e708. doi: 10.1097/PEC.0000000000002461.
6
Neuroradiologic timing of intracranial hemorrhage in abusive head trauma.虐待性头部创伤中颅内出血的神经放射学时机
Pediatr Radiol. 2021 May;51(6):911-917. doi: 10.1007/s00247-020-04824-9. Epub 2021 May 17.
7
Utility of three-dimensional and reformatted head computed tomography images in the evaluation of pediatric abusive head trauma.三维及重建头 CT 图像在儿童外伤性颅脑损伤评估中的应用
Pediatr Radiol. 2021 May;51(6):927-938. doi: 10.1007/s00247-021-05025-8. Epub 2021 Apr 15.
8
Skull fractures in abusive head trauma: a single centre experience and review of the literature.虐待性头部外伤中的颅骨骨折:单中心经验和文献复习。
Childs Nerv Syst. 2021 Mar;37(3):919-929. doi: 10.1007/s00381-020-04870-6. Epub 2020 Sep 15.
9
Role of Susceptibility-Weighted Imaging in Detecting Retinal Hemorrhages in Children with Head Trauma.susceptibility加权成像在检测头部外伤儿童视网膜出血中的作用
Clin Neuroradiol. 2021 Sep;31(3):611-617. doi: 10.1007/s00062-020-00939-6. Epub 2020 Aug 5.
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MRI Findings in Pediatric Abusive Head Trauma: A Review.儿童虐待性头部外伤的 MRI 表现:综述。
J Neuroimaging. 2020 Jan;30(1):15-27. doi: 10.1111/jon.12670. Epub 2019 Nov 6.