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Effectiveness of low dose computed tomography to detect fractures in paediatric suspected physical abuse: a systematic review.
Doyle, Edel; Bugeja, Lyndal; Dimmock, Matthew R; Lee, Kam L; Ng, Jessica; Bassed, Richard B.
Afiliación
  • Doyle E; Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, VIC, 3004, Australia. edel.doyle@monash.edu.
  • Bugeja L; Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, VIC, 3004, Australia.
  • Dimmock MR; Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, VIC, Australia.
  • Lee KL; School of Allied Health Professions, Keele University, Keele, UK.
  • Ng J; Australian Radiation Protection and Nuclear Safety Agency, Yallambie, VIC, Australia.
  • Bassed RB; Cabrini Health, Melbourne, VIC, Australia.
Int J Legal Med ; 138(5): 1857-1866, 2024 Sep.
Article en En | MEDLINE | ID: mdl-38619573
ABSTRACT

PURPOSE:

The skeletal survey X-ray series is the current 'gold standard' when investigating suspected physical abuse (SPA) of children, in addition to a non-contrast computed tomography (CT) brain scan. This systematic literature review synthesised findings of published research to determine if low dose computed tomography (LDCT) could detect subtle fractures and therefore replace the skeletal survey X-ray series in the investigation of SPA in children aged under 3 years.

METHODS:

Five electronic databases and grey literature were systematically searched from their inception to 28 April 2022. Primary studies were included where the population comprised paediatric patients up to 16 years and LDCT was used to detect fractures associated with SPA. Studies involving imaging investigations of the head, standard dose CT examinations or accidental trauma were excluded.

RESULTS:

Three studies met the inclusion criteria, all of which were case series. These studies did not report many of the criteria required to compare the accuracy of LDCT to X-ray, i.e. they did not meet the criteria for a diagnostic accuracy test. Therefore, it is difficult to conclude from the case series if LDCT is accurate enough to replace X-rays.

CONCLUSION:

Due to the gap in current literature, a phantom study and subsequent post-mortem CT study are recommended as the primary investigative methods to assess the ability of low-dose CT to identify the subtle fractures associated with SPA and to calculate how low the achievable CT dose can be.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dosis de Radiación / Tomografía Computarizada por Rayos X / Maltrato a los Niños / Fracturas Óseas Límite: Child / Child, preschool / Humans / Infant Idioma: En Revista: Int J Legal Med Asunto de la revista: JURISPRUDENCIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dosis de Radiación / Tomografía Computarizada por Rayos X / Maltrato a los Niños / Fracturas Óseas Límite: Child / Child, preschool / Humans / Infant Idioma: En Revista: Int J Legal Med Asunto de la revista: JURISPRUDENCIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania