本文選題：鼻骨線性骨折 + MSCT�。� 參考：《青島大學(xué)》2016年碩士論文

【摘要】：目的:鼻骨骨折作為運動受傷、沖突受傷、車禍?zhǔn)軅�、摔倒面部著地受傷等外傷的常見受傷部�?多帶有糾紛性質(zhì),線性骨折的判定對于輕微傷、輕傷的鑒別有指導(dǎo)意義,其定性診斷對于治療及事故的鑒定有指導(dǎo)意義,而鼻骨骨折受解剖機(jī)構(gòu)及檢查方法的影響漏診率誤診率較高,隨著影像檢查技術(shù)及后處理技術(shù)的發(fā)展鼻骨骨折診斷正確率明顯的提高,本文重點討論多層螺旋CT鼻骨曲面重組(MSCT CPR)技術(shù)在鼻骨線性骨折的法醫(yī)鑒定中的應(yīng)用價值。材料與方法:收集青島大學(xué)附屬醫(yī)院2013年1月1日至2014年12月31日因顱面部外傷需要法醫(yī)學(xué)鑒定進(jìn)行CT檢查的患者。本組資料共計98例,其中男性72例,女性26例,年齡15~70Y,平均年齡43歲,設(shè)備采用荷蘭Philips256層i CT機(jī),對比使用MSCT CPR技術(shù)、MSCT軸位平掃、多平面重組(MPR)對2013年1月1日至2014年12月31日因頭面部外傷入院進(jìn)行法醫(yī)學(xué)鑒定的患者進(jìn)行檢查,收集臨床資料,分析檢查結(jié)果,檢驗多層螺旋CT曲面重組(MSCT CPR)對鼻骨骨折的診斷特異性。結(jié)果:98例患者,CT軸位平掃診斷結(jié)果鼻骨正常29例,診斷鼻骨可疑線性骨折69例,陽性率為70.4%MSCT CPR診斷結(jié)果鼻骨正常20例,鼻骨可疑線性骨折78例,真實陽性率為79.6%。其中CT軸位平掃與MSCT CPR均診斷為鼻骨正常者15例,兩者均診斷為線性骨折者64例,CT軸位平掃診斷為鼻骨正常而MSCT CPR診斷為線性骨折者14例,CT軸位平掃診斷為鼻骨骨折而MSCT CPR診斷為鼻骨正常者5例。結(jié)論:CT曲面重組圖像能有效的分辨骨折與鼻骨正常解剖結(jié)構(gòu),結(jié)合常規(guī)CT檢查,能夠降低鼻骨線性骨折誤診及漏診率,提高鼻骨輕微傷的法醫(yī)學(xué)鑒定的參考價值。目前,針對鼻骨進(jìn)行曲面重組的研究臨床實踐相對較少,若結(jié)合常規(guī)CT檢查,尤其是HRCT檢查,對鼻骨骨折診斷價值更高。
[Abstract]:Objective: as the common injury sites of sports injury, conflict injury, traffic accident injury, falling face injury and so on, the nasal bone fracture has the dispute nature, the judgment of the linear fracture has the guiding significance for the differential diagnosis of the slight injury and the slight injury. The qualitative diagnosis is of guiding significance for the treatment and identification of accidents, while the misdiagnosis rate of nasal fracture is higher due to the influence of anatomical organization and examination methods. With the development of imaging and post-processing techniques, the diagnostic accuracy of nasal fracture has been improved significantly. This paper focuses on the application of MSCT CPR in the forensic identification of nasal bone linear fracture. Materials and methods: from January 1, 2013 to December 31, 2014, the patients with craniofacial trauma who needed forensic medical examination were collected from the affiliated Hospital of Qingdao University. A total of 98 cases, including 72 males and 26 females, with an average age of 43 years, were enrolled in this study. The equipment was performed with Philips256 slice I CT in the Netherlands. MSCT CPR technique was used to contrast the axial plain scan of MSCT. From January 1, 2013 to December 31, 2014, patients admitted to hospital for head and facial trauma were examined by MPRs. The clinical data were collected and the results were analyzed. To examine the specificity of MSCT CPR in diagnosis of nasal fracture. Results 29 cases of nasal bone were normal by axial plain CT scan, 69 cases were diagnosed suspected linear fracture of nasal bone. The positive rate was 70.4 MSCT CPR in 20 cases of normal nasal bone and 78 cases of suspected linear fracture of nasal bone. The true positive rate was 79.6%. Ct axial plain scan and MSCT CPR were all diagnosed as normal nasal bone in 15 cases. In both cases, 64 cases of linear fracture were diagnosed by CT axial plain scan, 14 cases by MSCT CPR were diagnosed as linear fracture, and 5 cases were diagnosed as normal nasal bone by MSCT CPR. Conclusion the curved surface recombination image of CT can effectively distinguish fracture from normal anatomical structure of nasal bone, combined with routine CT examination, it can reduce the misdiagnosis rate and missed diagnosis rate of linear fracture of nasal bone, and improve the reference value of forensic medical identification of slight injury of nasal bone. At present, the clinical practice of curved surface reconstruction of nasal bone is relatively few. If combined with conventional CT examination, especially HRCT, it is more valuable for the diagnosis of nasal bone fracture.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：D919.4
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本文編號：2033747