引言
受虐(挨打)儿童综合征， 摇婴综合征, 对婴儿滥用胁迫。这些术语都是用来描述在婴儿和幼儿期的非意外伤害。
足月时的摇婴综合症，大概最能描述经典模式中受伤。.
孩子是被拿住胸部四周猛烈的来回摇。
this causes the extremities and the head to flail back and forth in a whiplash movement.
颅内的损伤是由于发生了激烈的角加速, 减速和头部正碰到坚实的物体上造成的。
胸部压缩，造成肋骨骨折。
手臂和腿在挥鞭样的剧烈运动中造成典型的“corner”及 “bucket-handle骨折”发生于干骺端的局部。
放射科的作用
有能力鉴别儿童癖嗜constitutes an important concern来自那些棘手的在儿童医疗保健中.
研究报告显示，至少有10%的5岁以下儿童被带到急诊室的时候被说成意外事故，但事实上婴儿遭受了非意外创伤。
由于有多达65 ％的虐待案件最初都是出现在急诊室中，首要的一步，在正确鉴别虐待是要进行培训，医院的工作人员要认识到滥用的标准。
广泛的调查结果，which can mimic other疾病过程, 结果在误诊的多数病例中头部被创伤。
珍妮和他的同事报告说有31 ％的被证实滥用的头部创伤案例是误诊在最初显示和多数婴儿持续的附加的损伤因为延误诊断。
骨骼损伤
当我们在急诊科看x-光片了解到, 要使婴儿和小孩的骨头断裂是需要足够的力的。
任何骨折在这个年龄组当中显示较多的是外伤事件,这种外伤决绝是像高低处跌倒那样的。
典型的干骺端角样及桶柄样的骨折事实上是为虐待的特异性表现。
在少于2年的受虐儿童中，肋骨骨折是普遍存在的且具有很高的特异性。
来自肩部的胸骨和棘突的骨折是少见的, that this affords them a high specificity for abuse.
枕骨及其他颅骨骨折发生时，是头部撞击到坚实的物体。
上图桶柄骨折发生在胫骨近端。 该干骺端的骨折的碎片可以看到成圆盘或桶柄样。 桶柄骨折
事实上这些骨折一样是角样骨折
the avulsed bone fragment is larger and seen '；en face'； as a disc or bucket handle.
这些角样与桶柄骨折最普遍发生在胫骨, 远侧股骨和肱骨近端。
骨折经常是双侧性的发生。
肋骨骨折
在猛烈的摇动儿童，是非常紧的抱住胸部四周 和挤压伤while being shaken.
这个力量使肋骨前到后断裂，紧靠附件到椎骨这之间的几乎断了一半。
因此，侧面和后面的肋骨骨折要高度怀疑是否为虐待所致。
心肺复苏术是很少见，如果真的，是造可以造成这种骨折。
这些肋骨骨折，在用到被虐待的儿童，同时顺便发现胸部x光片表现为其他原因，如评价为肺炎。
child abuse is a relatively common problem in our society.
在我们的社会中，儿童受虐是相对常见的问题。
in the u.s it is estimated that 4 million children a year are abused in some manner.
据估计在美国每年有4百万个儿童遭受某种方式的虐待，
at least two thousand children die as a result of this abuse.
至少有二千个儿童死于受虐。
this overview focusses on the role of diagnostic imaging in depicting the findings that are specific for child abuse.
本文着重于针对描述儿童受虐方面研究成果，讨论医学影像诊断所起的作用。
awareness of the radiologist is essential in finding these skeletal and cns injuries in order to document child abuse, to stop further abuse and to protect siblings.
为了给受虐儿童提供书证、阻止虐待的进一步发生及保护弱小，非常必要提高放射工作人员对旨在发现能证明受虐存在的骨骼及中枢神经损伤方面的诊断意识。
introduction
battered child syndrome, shaken infant syndrome, stress-related infant abuse and non accidental trauma are all terms to describe the complex of non-accidental injuries in infants and young children as a result of abuse.
受折磨儿童综合症、受震荡婴儿综合症、受虐婴儿应激症和非意外创伤都被用来作为定义婴幼儿由于受虐导致的非意外伤害的专业术语。
the term shaken infant syndrome probably best describes the classic pattern of injuries.
受震荡婴儿综合征可能是对这种典型损伤最形象的定义术语
the child is held around the chest and violently shaken back and forth.
儿童被环胸握持着剧烈的前后震荡
this causes the extremities and the head to flail back and forth in a whiplash movement.
这使受虐儿童头部及四肢连枷前后做甩鞭样运动
intracranial injury occurs as a result of severe angular acceleration, deceleration and direct impact as the head strikes a solid object.
颅内组织由于剧烈的加速、减速作用或当头撞击于坚硬的物体的直接作用而造成伤害。
the chest is compressed resulting in rib fractures. 胸部受挤压而导致肋骨骨折
arms and legs move about in a whiplash movement resulting in the typical '；corner'； or '；bucket-handle'；-fractures in the metaphyseal region. 手臂及腿由于这种甩鞭样运动在干骺端形成典型的“角部”或“桶把”样骨折。
role of the radiologist
放射工作人员的作用
the ability to identify child abuse constitutes an important concern to those involved in the medical care of children. 放射人员鉴定儿童受虐的能力，在那些由此就医儿童的诊断中起着至关重要的作用。
studies show that at least 10% of children under 5 years old who are brought to the emergency room with alleged accidents have actually suffered nonaccidental trauma.研究显示在5岁以下声称意外事件受伤而急诊就医的儿童中至少有10%实际是受到了非意外创伤。
since as many as 65% of all abuse cases are initially seen in the emergency room, the first step in correctly identifying abuse is to train hospital staff members to recognize abuse indicators.既然多达65%的受虐儿童首先到急诊室就诊，为正确识别受虐伤害，第一步要做的就是培训医疗人员对受虐征象的认识。
the wide range of findings, which can mimic other disease processes, results in misdiagnosis of many cases of inflicted head trauma.由于临床征象范围太宽，可能被当做其他疾病的病理过程，导致涉及头部创伤的多数病例被误诊。
jenny and colleagues reported that 31% of confirmed abusive head trauma cases were missed on initial presentation and many infants sustained additional injury because of the delay in diagnosis.珍妮和同事的报道称在被确诊为受虐性头部创伤的患儿中，有31%病例在初诊中被错失机会，并由于延误诊断而使许多婴儿遭受持续的额外伤害。
the radiologist can be the first to suggest the diagnosis on the basis of ct studies performed to evaluate for seizures or other neurologic symptoms or on x-rays performed for other reasons.放射人员可能在基于ct图像诊断癫痫或其他神经学症状及由于其他原因而进行x线检查中首先发现异常并提示诊断。
a high degree of suspicion, inability to explain the degree of injury or a reported mechanism of injury, that is inconsistent with the physical findings should alert the radiologist to possible作者: 有风的日子 时间: 2008-4-3 04:35
版主的英文水平太差，翻译的东西比英文还难懂！上面是本人全文翻译，中英文对照（缺点是没图），希望对大家有所帮助。作者: 有风的日子 时间: 2008-4-3 04:40
所有英文全部译出，版面所限没完全显示出来，希望站长能帮一下大家的忙！作者: ZHANGZHONGSHOU 时间: 2008-4-3 06:20 标题: 回复：zt0191:儿童痞嗜的影像学诊断 [quote]以下是引用有风的日子在2008-4-2 20:30:00的发言：[br][br]diagnostic imaging in child abuse [br]儿童受虐症的影像学诊断[br][br][br]child abuse is a relatively common problem in our society.[br]在我们的社会中，儿童受虐是相对常见的问题。[br]in the u.s it is estimated that 4 million children a year are abused in some manner.[br]据估计在美国每年有4百万个儿童遭受某种方式的虐待，[br]at least two thousand children die as a result of this abuse. [br]至少有二千个儿童死于受虐。[br]this overview focusses on the role of diagnostic imaging in depicting the findings that are specific for child abuse.[br]本文着重于针对描述儿童受虐方面研究成果，讨论医学影像诊断所起的作用。[br]awareness of the radiologist is essential in finding these skeletal and cns injuries in order to document child abuse, to stop further abuse and to protect siblings. [br]为了给受虐儿童提供书证、阻止虐待的进一步发生及保护弱小，非常必要提高放射工作人员对旨在发现能证明受虐存在的骨骼及中枢神经损伤方面的诊断意识。[br] introduction [br] battered child syndrome, shaken infant syndrome, stress-related infant abuse and non accidental trauma are all terms to describe the complex of non-accidental injuries in infants and young children as a result of abuse.[br]受折磨儿童综合症、受震荡婴儿综合症、受虐婴儿应激症和非意外创伤都被用来作为定义婴幼儿由于受虐导致的非意外伤害的专业术语。[br]the term shaken infant syndrome probably best describes the classic pattern of injuries. [br]受震荡婴儿综合征可能是对这种典型损伤最形象的定义术语[br]the child is held around the chest and violently shaken back and forth. [br]儿童被环胸握持着剧烈的前后震荡[br]this causes the extremities and the head to flail back and forth in a whiplash movement. [br]这使受虐儿童头部及四肢连枷前后做甩鞭样运动[br]intracranial injury occurs as a result of severe angular acceleration, deceleration and direct impact as the head strikes a solid object. [br]颅内组织由于剧烈的加速、减速作用或当头撞击于坚硬的物体的直接作用而造成伤害。[br]the chest is compressed resulting in rib fractures. 胸部受挤压而导致肋骨骨折[br]arms and legs move about in a whiplash movement resulting in the typical '；corner'； or '；bucket-handle'；-fractures in the metaphyseal region. 手臂及腿由于这种甩鞭样运动在干骺端形成典型的“角部”或“桶把”样骨折。[br][br] role of the radiologist [br]放射工作人员的作用[br][br] the ability to identify child abuse constitutes an important concern to those involved in the medical care of children. 放射人员鉴定儿童受虐的能力，在那些由此就医儿童的诊断中起着至关重要的作用。[br]studies show that at least 10% of children under 5 years old who are brought to the emergency room with alleged accidents have actually suffered nonaccidental trauma.研究显示在5岁以下声称意外事件受伤而急诊就医的儿童中至少有10%实际是受到了非意外创伤。[br]since as many as 65% of all abuse cases are initially seen in the emergency room, the first step in correctly identifying abuse is to train hospital staff members to recognize abuse indicators.既然多达65%的受虐儿童首先到急诊室就诊，为正确识别受虐伤害，第一步要做的就是培训医疗人员对受虐征象的认识。[br]the wide range of findings, which can mimic other disease processes, results in misdiagnosis of many cases of inflicted head trauma.由于临床征象范围太宽，可能被当做其他疾病的病理过程，导致涉及头部创伤的多数病例被误诊。[br]jenny and colleagues reported that 31% of confirmed abusive head trauma cases were missed on initial presentation and many infants sustained additional injury because of the delay in diagnosis.珍妮和同事的报道称在被确诊为受虐性头部创伤的患儿中，有31%病例在初诊中被错失机会，并由于延误诊断而使许多婴儿遭受持续的额外伤害。 [br] the radiologist can be the first to suggest the diagnosis on the basis of ct studies performed to evaluate for seizures or other neurologic symptoms or on x-rays performed for other reasons.放射人员可能在基于ct图像诊断癫痫或其他神经学症状及由于其他原因而进行x线检查中首先发现异常并提示诊断。[br]a high degree of suspicion, inability to expl作者: wnlyq8688 时间: 2008-4-4 18:39
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