PDF(Pubmed)
Abstract：
OBJECTIVE: To assess the accuracy of CT and MRI reports of alert patients presenting after non-self-inflicted strangulation (NSIS) and evaluate the appropriateness of these imaging modalities in NSIS.
METHODS: The study was a retrospective analysis of patient characteristics and strangulation details, with a comparison of original radiology reports (ORR) to expert read-outs (EXR) of CT and MRI studies of all NSIS cases seen from 2008 to 2020 at a single centre.
RESULTS: The study included 116 patients (71% women, p < .001, χ2), with an average age of 33.8 years, mostly presenting after manual strangulation (97%). Most had experienced intimate partner violence (74% of women, p < .001, χ2) or assault by unknown offender (88% of men, p < 0.002 χ2). Overall, 132 imaging studies (67 CT, 51% and 65 MRI, 49%) were reviewed. Potentially dangerous injuries were present in 7%, minor injuries in 22%, and no injuries in 71% of patients. Sensitivity and specificity of ORR were 78% and 97% for MRI and 30% and 98% for CT. Discrepancies between ORR and EXR occurred in 18% of all patients, or 62% of injured patients, with a substantial number of unreported injuries on CT.
CONCLUSIONS: The results indicate that MRI is more appropriate than CT for alert patients presenting after non-self-inflicted strangulation and underline the need for radiologists with specialist knowledge to report these cases in order to add value to both patient care and potential future medico-legal investigations.
CONCLUSIONS: MRI should be preferred over CT for the investigation of strangulation related injuries in alert patients because MRI has a higher accuracy than CT and does not expose this usually young patient population to ionizing radiation.
CONCLUSIONS: • Patients presenting after strangulation are often young women with a history of intimate partner violence while men typically present after assault by an unknown offender. • Expert read-outs of CT and MRI revealed potentially dangerous injuries in one of 14 patients. • MRI has a significantly higher sensitivity than CT and appears to be more appropriate for the diagnostic workup of alert patients after strangulation.
METHODS: The study was a retrospective analysis of patient characteristics and strangulation details, with a comparison of original radiology reports (ORR) to expert read-outs (EXR) of CT and MRI studies of all NSIS cases seen from 2008 to 2020 at a single centre.
RESULTS: The study included 116 patients (71% women, p < .001, χ2), with an average age of 33.8 years, mostly presenting after manual strangulation (97%). Most had experienced intimate partner violence (74% of women, p < .001, χ2) or assault by unknown offender (88% of men, p < 0.002 χ2). Overall, 132 imaging studies (67 CT, 51% and 65 MRI, 49%) were reviewed. Potentially dangerous injuries were present in 7%, minor injuries in 22%, and no injuries in 71% of patients. Sensitivity and specificity of ORR were 78% and 97% for MRI and 30% and 98% for CT. Discrepancies between ORR and EXR occurred in 18% of all patients, or 62% of injured patients, with a substantial number of unreported injuries on CT.
CONCLUSIONS: The results indicate that MRI is more appropriate than CT for alert patients presenting after non-self-inflicted strangulation and underline the need for radiologists with specialist knowledge to report these cases in order to add value to both patient care and potential future medico-legal investigations.
CONCLUSIONS: MRI should be preferred over CT for the investigation of strangulation related injuries in alert patients because MRI has a higher accuracy than CT and does not expose this usually young patient population to ionizing radiation.
CONCLUSIONS: • Patients presenting after strangulation are often young women with a history of intimate partner violence while men typically present after assault by an unknown offender. • Expert read-outs of CT and MRI revealed potentially dangerous injuries in one of 14 patients. • MRI has a significantly higher sensitivity than CT and appears to be more appropriate for the diagnostic workup of alert patients after strangulation.
摘要：
目的：评估非自我绞窄（NSIS）后表现出警觉的患者的CT和MRI报告的准确性，并评估这些成像方式在NSIS中的适用性。
方法：该研究是对患者特征和绞窄细节的回顾性分析，将2008年至2020年在一个中心观察到的所有NSIS病例的CT和MRI研究的原始放射学报告（ORR）与专家读数（EXR）进行比较。
结果：该研究包括116名患者（71％为女性，p<.001，χ2)，平均年龄为33.8岁，主要是在手动勒死后出现(97%)。大多数人经历过亲密伴侣暴力(74%的女性，p<.001，χ2)或不明罪犯的袭击(88%的男性，p<0.002χ2)。总的来说,132项影像学检查(67项CT，51％和65MRI，49%)进行了审查。潜在的危险伤害占7%，22％的轻伤，71%的患者没有受伤。ORR的敏感性和特异性分别为MRI的78％和97％，CT的30％和98％。ORR和EXR之间的差异发生在所有患者的18％，或62%的受伤患者，CT上有大量未报告的损伤。
结论：结果表明，MRI比CT更适合于非自我绞窄后表现出警觉的患者，并强调需要具有专业知识的放射科医生报告这些病例，以便为患者护理和潜在的未来医学法律调查增加价值。
结论：在警觉患者的绞窄相关损伤的调查中，MRI应优于CT，因为MRI比CT具有更高的准确性，并且不会使这种通常年轻的患者群体暴露于电离辐射。
结论：•勒死后出现的患者通常是有亲密伴侣暴力史的年轻女性，而男性通常在受到不明罪犯攻击后出现。•CT和MRI的专家读数显示，14例患者中有1例受到潜在危险伤害。•MRI的灵敏度明显高于CT，似乎更适合绞窄后机敏患者的诊断检查。
方法：该研究是对患者特征和绞窄细节的回顾性分析，将2008年至2020年在一个中心观察到的所有NSIS病例的CT和MRI研究的原始放射学报告（ORR）与专家读数（EXR）进行比较。
结果：该研究包括116名患者（71％为女性，p<.001，χ2)，平均年龄为33.8岁，主要是在手动勒死后出现(97%)。大多数人经历过亲密伴侣暴力(74%的女性，p<.001，χ2)或不明罪犯的袭击(88%的男性，p<0.002χ2)。总的来说,132项影像学检查(67项CT，51％和65MRI，49%)进行了审查。潜在的危险伤害占7%，22％的轻伤，71%的患者没有受伤。ORR的敏感性和特异性分别为MRI的78％和97％，CT的30％和98％。ORR和EXR之间的差异发生在所有患者的18％，或62%的受伤患者，CT上有大量未报告的损伤。
结论：结果表明，MRI比CT更适合于非自我绞窄后表现出警觉的患者，并强调需要具有专业知识的放射科医生报告这些病例，以便为患者护理和潜在的未来医学法律调查增加价值。
结论：在警觉患者的绞窄相关损伤的调查中，MRI应优于CT，因为MRI比CT具有更高的准确性，并且不会使这种通常年轻的患者群体暴露于电离辐射。
结论：•勒死后出现的患者通常是有亲密伴侣暴力史的年轻女性，而男性通常在受到不明罪犯攻击后出现。•CT和MRI的专家读数显示，14例患者中有1例受到潜在危险伤害。•MRI的灵敏度明显高于CT，似乎更适合绞窄后机敏患者的诊断检查。
