2003年僅僅在美國，就有大約906000兒童成為被忽視或者虐待的犧牲品，而放射科醫(yī)生在幫助此類所謂虐待案件法庭程序終結(jié)的過程中，發(fā)揮著關(guān)鍵作用。

根據(jù)肯塔基大學醫(yī)學中心研究人員的結(jié)果，可以使用放射學以及其它影像掃描方法來發(fā)現(xiàn)許多虐待事件的跡象。該醫(yī)學中心已經(jīng)收集來自肯塔基大學醫(yī)學中心的許多案例，組織了一次互動式展覽，來幫助放射科醫(yī)生準確地診斷兒童虐待事件。

肯塔基大學的Andrea Walker指出，在還不能走路的兒童，如果放射科醫(yī)生在愈合不同階段發(fā)現(xiàn)骨折，在長骨末端發(fā)現(xiàn)骨折（這通常發(fā)生在兒童被搖晃的情況之下），背部肋骨骨折，長骨骨折，應當引起高度重視。而且可以使用核磁共振掃描來鑒別反復出血，核磁共振波譜檢查能夠檢測升高的乳酸水平，這通常發(fā)生在低氧損害（氧氣喪失或者缺乏）的情況之下。

Walder博士說：“另外一方面，有些疾病可能會被誤認為虐待。例如，代謝性骨骼疾病，例如成骨不全，會在放射學檢查的時候表現(xiàn)為反復骨折，這可以在兒童虐待的時候發(fā)生。但是如果我們重新核實，會發(fā)現(xiàn)所有骨骼都不正常，我們就可以十分自信的說這個孩子正遭受疾病而不是虐待的折磨。所謂的兒童虐待事件常常在法庭終結(jié)，而放射科醫(yī)生在這類事件中扮演重要角色因為放射檢查是客觀證據(jù)。這類檢查必須仔細應對。”

2005年5月新奧爾良美國倫琴射線學會年會上展示了該研究結(jié)果的電子展示。

Radiologists Help Identify Child Abuse
 
In the United States alone, approximately 906,000 children were victims of neglect or abuse in 2003, and radiologists are playing a crucial role when these cases of alleged abuse end up in court proceedings.

There are a host of indicators of abuse that can be seen using radiography and other imaging methods, according to researchers at the University of Kentucky Medical Center (Lexington, KY, USA), who have comprised an interactive exhibit of cases from the University of Kentucky Medical Center to help radiologists accurately diagnose child abuse.

A red flag should appear when a radiologist discovers fractures in different stages of healing, fractures at the very end of the long bones (which can occur when a child has been shaken), posterior rib fractures, and long-bone fractures in children who are not walking, said Andrea Walker, DO, from the University of Kentucky. Furthermore, magnetic resonance imaging (MRI) of the brain can identify repeated hemorrhages, and MR spectroscopy can detect increased lactate levels, which are found in hypoxic (loss or reduction of oxygen) injuries.

“On the other hand, there are a number of diseases and disorders that could potentially be mistaken for abuse,” said Dr. Walker. “For example, metabolic bone diseases, such as osteogenesis imperfecta, can show up on a radiologic examination as multiple fractures, which can also be seen in abuse. However, if we take a second look, and see that all the bones are abnormal, we can be confident that the child suffers from a disease rather than abuse. Cases of alleged child abuse often end up in the courtroom and the radiologist is a critical component of the case because radiographs are objective data. It is crucial to be well informed.”

The electronic exhibit was displayed at the annual meeting of the American Roentgen Ray Society in New Orleans in May 2005.