溺死虚拟解剖研究进展
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摘要
水中尸体并非都是溺死,法医学鉴定的重要任务是区别生前入水和死后入水,明确死亡原因。法医学鉴定实践中,溺死一般依据尸体征象、组织病理学检验和硅藻检验等综合考虑,并需要排除其他死亡原因。虚拟解剖技术的出现为溺死的诊断提供了新的思路。本文综述了国内外近年来对溺死尸体的鼻窦与乳突小房、呼吸道、肺组织、胃肠道和血液等死后的影像学研究成果,探讨虚拟解剖技术在溺死诊断应用上的价值与潜力,并对溺死虚拟解剖的发展方向进行展望。
Dead bodies found in the water are not all caused by drowning. The important task of forensic identification is to distinguish between entering the water before and after death, and to clarify the cause of death. In the practice of forensic identification, drowning is generally diagnosed on the basis of comprehensive considerations such as cadaveric signs, histopathological examinations, and diatom tests, with the exclusion of other causes of death. The emergence of virtopsy techniques provides new insights for the diagnosis of drowning. This paper reviews the post-mortem imaging studies of sinus and mastoid small chambers, respiratory tracts, lung tissues, gastrointestinal tracts and blood in the corpses in recent years. The value, potential of virtopsy in the diagnosis of drowning is discussed,with the prospects of its development direction.
Dead bodies found in the water are not all caused by drowning. The important task of forensic identification is to distinguish between entering the water before and after death, and to clarify the cause of death. In the practice of forensic identification, drowning is generally diagnosed on the basis of comprehensive considerations such as cadaveric signs, histopathological examinations, and diatom tests, with the exclusion of other causes of death. The emergence of virtopsy techniques provides new insights for the diagnosis of drowning. This paper reviews the post-mortem imaging studies of sinus and mastoid small chambers, respiratory tracts, lung tissues, gastrointestinal tracts and blood in the corpses in recent years. The value, potential of virtopsy in the diagnosis of drowning is discussed,with the prospects of its development direction.
引文
[1]赵子琴.法医病理学[M].4版.北京:人民卫生出版社,2009:316-317,321.
[2]LUNETTA P,MODELL J H,SAJANTILA A.What is the incidence and significance of“dry-lungs”in bodies found in water?[J].Am J Forensic Med Pathol,2004,25(4):291-301.
[3]PEABODY A J.Diatoms and drowning--a review[J].Med Sci Law,1980,20(4):254-261.
[4]ANTONENKO N E.Diatom analysis lives on[J].Can Soc Forensic Sci J,1987,20(4):101-102.
[5]PIETTE M H,de LETTER E A.Drowning:Still a difficult autopsy diagnosis[J].Forensic Sci Int,2006,163(1/2):1-9.
[6]GRABHERR S,EGGER C,VILARINO R,et al.Modern post-mortem imaging:An update on recent developments[J].Forensic Sci Res,2017,2(2):52-64.
[7]CHEN Y.State of the art in post-mortem forensic imaging in China[J].Forensic Sci Res,2017,2(2):75-84.
[8]DIRNHOFER R,JACKOWSKI C,VOCK P,et al.Virtopsy:Minimally invasive,imaging-guided virtual autopsy[J].Radiographics,2006,26(5):1305-1333.
[9]AGHAYEV E,THALI M J,SONNENSCHEIN M,et al.Fatal steamer accident;blunt force injuries and drowning in post-mortem MSCT and MRI[J].Forensic Sci Int,2005,152(1):65-71.
[10]万雷,郑剑,应充亮,等.多层螺旋CT虚拟解剖判定溺死1例[J].法医学杂志,2010,26(6):469-471.
[11]LEVY A D,HARCKE H T,GETZ J M,et al.Virtual autopsy:Two-and three-dimensional multidetector CT findings in drowning with autopsy comparison[J].Radiology,2007,243(3):862-868.
[12]CHRISTE A,AGHAYEV E,JACKOWSKI C,et al.Drowning--post-mortem imaging findings by computed tomography[J].Eur Radiol,2008,18(2):283-290.
[13]KAWASUMI Y,KAWABATA T,SUGAI Y,et al.Assessment of the relationship between drowning and fluid accumulation in the paranasal sinuses on post-mortem computed tomography[J].Eur J Radiol,2012,81(12):3953-3955.
[14]KAWASUMI Y,KAWABATA T,SUGAI Y,et al.Diagnosis of drowning using post-mortem computed tomography based on the volume and density of fluid accumulation in the maxillary and sphenoid sinuses[J].Eur J Radiol,2013,82(10):e562-e566.
[15]KAWASUMI Y,USUI A,SATO Y,et al.Distinction between saltwater drowning and freshwater drowning by assessment of sinus fluid on postmortem computed tomography[J].Eur Radiol,2016,26(4):1186-1190.
[16]PLAETSEN S V,DE LETTER E,PIETTE M,et al.Post-mortem evaluation of drowning with whole body CT[J].Forensic Sci Int,2015,249:35-41.
[17]van HOYWEGHEN A J,JACOBS W,OP de BEECK B,et al.Can post-mortem CT reliably distinguish between drowning and non-drowning asphyxiation?[J].Int J Legal Med,2015,129(1):159-164.
[18]VERSCHAKELEN J A,de WEVER W.Computed tomogaphy of the lung[M].Verlag:Springer,2007.
[19]USUI A,KAWASUMI Y,FUNAYAMA M,et al.Postmortem lung features in drowning cases on computed tomography[J].Jpn J Radiol,2014,32(7):414-420.
[20]AMBROSETTI M C,BARBIANI C,EL-DALATIG,et al.Virtual autopsy using multislice computed tomography in forensic medical diagnosis of drowning[J].Radiol Med,2013,118(4):679-687.
[21]BATTISTA G,SASSI C,ZOMPATORI M,et al.Ground-glass opacity:Interpretation of high resolution CT findings[J].Radiol Med,2003,106(5/6):425-442,443-444.
[2]LUNETTA P,MODELL J H,SAJANTILA A.What is the incidence and significance of“dry-lungs”in bodies found in water?[J].Am J Forensic Med Pathol,2004,25(4):291-301.
[3]PEABODY A J.Diatoms and drowning--a review[J].Med Sci Law,1980,20(4):254-261.
[4]ANTONENKO N E.Diatom analysis lives on[J].Can Soc Forensic Sci J,1987,20(4):101-102.
[5]PIETTE M H,de LETTER E A.Drowning:Still a difficult autopsy diagnosis[J].Forensic Sci Int,2006,163(1/2):1-9.
[6]GRABHERR S,EGGER C,VILARINO R,et al.Modern post-mortem imaging:An update on recent developments[J].Forensic Sci Res,2017,2(2):52-64.
[7]CHEN Y.State of the art in post-mortem forensic imaging in China[J].Forensic Sci Res,2017,2(2):75-84.
[8]DIRNHOFER R,JACKOWSKI C,VOCK P,et al.Virtopsy:Minimally invasive,imaging-guided virtual autopsy[J].Radiographics,2006,26(5):1305-1333.
[9]AGHAYEV E,THALI M J,SONNENSCHEIN M,et al.Fatal steamer accident;blunt force injuries and drowning in post-mortem MSCT and MRI[J].Forensic Sci Int,2005,152(1):65-71.
[10]万雷,郑剑,应充亮,等.多层螺旋CT虚拟解剖判定溺死1例[J].法医学杂志,2010,26(6):469-471.
[11]LEVY A D,HARCKE H T,GETZ J M,et al.Virtual autopsy:Two-and three-dimensional multidetector CT findings in drowning with autopsy comparison[J].Radiology,2007,243(3):862-868.
[12]CHRISTE A,AGHAYEV E,JACKOWSKI C,et al.Drowning--post-mortem imaging findings by computed tomography[J].Eur Radiol,2008,18(2):283-290.
[13]KAWASUMI Y,KAWABATA T,SUGAI Y,et al.Assessment of the relationship between drowning and fluid accumulation in the paranasal sinuses on post-mortem computed tomography[J].Eur J Radiol,2012,81(12):3953-3955.
[14]KAWASUMI Y,KAWABATA T,SUGAI Y,et al.Diagnosis of drowning using post-mortem computed tomography based on the volume and density of fluid accumulation in the maxillary and sphenoid sinuses[J].Eur J Radiol,2013,82(10):e562-e566.
[15]KAWASUMI Y,USUI A,SATO Y,et al.Distinction between saltwater drowning and freshwater drowning by assessment of sinus fluid on postmortem computed tomography[J].Eur Radiol,2016,26(4):1186-1190.
[16]PLAETSEN S V,DE LETTER E,PIETTE M,et al.Post-mortem evaluation of drowning with whole body CT[J].Forensic Sci Int,2015,249:35-41.
[17]van HOYWEGHEN A J,JACOBS W,OP de BEECK B,et al.Can post-mortem CT reliably distinguish between drowning and non-drowning asphyxiation?[J].Int J Legal Med,2015,129(1):159-164.
[18]VERSCHAKELEN J A,de WEVER W.Computed tomogaphy of the lung[M].Verlag:Springer,2007.
[19]USUI A,KAWASUMI Y,FUNAYAMA M,et al.Postmortem lung features in drowning cases on computed tomography[J].Jpn J Radiol,2014,32(7):414-420.
[20]AMBROSETTI M C,BARBIANI C,EL-DALATIG,et al.Virtual autopsy using multislice computed tomography in forensic medical diagnosis of drowning[J].Radiol Med,2013,118(4):679-687.
[21]BATTISTA G,SASSI C,ZOMPATORI M,et al.Ground-glass opacity:Interpretation of high resolution CT findings[J].Radiol Med,2003,106(5/6):425-442,443-444.