Fauré C, Kalifa G, Sellier N
Hôpital d'Enfants Armand-Trousseau, Paris.
J Radiol. 1994 Nov;75(11):619-27.
Imaging procedures offer an important contribution to the syndrome of the abused child that F.N. Silverman himself proposes to call the Ambroise Tardieu syndrome. First they disclose and analyse the lesions which may involve bones, encephalon or spinal cord, viscera, soft tissues. Then they must answer four questions: Traumatic lesion or normal variant? If traumatic, are there arguments pointing to abuse, for instance multiple bone lesions of different ages and more specifically fractures of ribs, clavicle, spine, pelvis, phalanxes? Is there a possibility of a general disease explaining such traumatic lesions? Etiologies are revised including sensibility deficits. Finally are the bad treatments inflicted with an intention of hurting, injuring or destroying? The answer results of a discussion with clinicians and social interveners but some lesions, as phalanx fractures, may be determining. In this situation that involves the vital prognosis and may induce severe sequellae the imaging strategy, fully described, is of paramount importance.
影像学检查对受虐儿童综合征有重要贡献，F.N. 西尔弗曼本人提议将该综合征称为安布鲁瓦兹·塔尔迪厄综合征。首先，影像学检查能揭示并分析可能累及骨骼、脑或脊髓、内脏、软组织的损伤。然后，它们必须回答四个问题：是创伤性损伤还是正常变异？如果是创伤性的，是否有指向虐待的证据，例如不同年龄段的多处骨骼损伤，更具体地说是肋骨、锁骨、脊柱、骨盆、指骨骨折？是否有可能存在一种全身性疾病来解释这种创伤性损伤？病因包括感觉缺陷等都要重新审视。最后，所施加的不当治疗是否有伤害、损伤或破坏的意图？答案来自与临床医生和社会干预人员的讨论，但某些损伤，如指骨骨折，可能具有决定性作用。在这种涉及生命预后并可能导致严重后遗症的情况下，详细描述的影像学检查策略至关重要。
