PM-CT在法医病理学中的应用现状与前景
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摘要
近年来,死后计算机断层扫描(postmortem computed tomography,PM-CT)受到国内外法医病理学者的重视。PM-CT因具有快速准确的成像能力、非侵入性解剖等优点而在颅脑损伤、猝死、交通事故、高坠等案件中具有重要的研究和应用价值,特别是在成伤机制的分析、证据保全、保存尸体完整性方面凸显优势。本文就PM-CT技术在法医病理学实践中的应用进行综述,以期为相关研究和实践提供参考和借鉴。
Forensic pathologists have recently attached great importance to the postmortem computed tomography(PMCT) for its research and application, orienting their cornerstone to set at the advantages of PM-CT being capable of getting rapidly and accurately the images with no intrusion of the autopsy bodies. Thus, there are important theoretical significances and application values for the examination of brain injury, sudden death, traffic-incident caused and high-fall death. This article reviews some latest advances on the application of PM-CT into forensic pathology, aiming to provide reference for the related research.
Forensic pathologists have recently attached great importance to the postmortem computed tomography(PMCT) for its research and application, orienting their cornerstone to set at the advantages of PM-CT being capable of getting rapidly and accurately the images with no intrusion of the autopsy bodies. Thus, there are important theoretical significances and application values for the examination of brain injury, sudden death, traffic-incident caused and high-fall death. This article reviews some latest advances on the application of PM-CT into forensic pathology, aiming to provide reference for the related research.
引文
[1]张继宗,车红民,徐理想.影像医学在法医学中的应用[J].法医学杂志,2006,22(2):153-155.
[2]汪冠三,苗春雨,王福磊,等.CT技术在法医人类学研究中应用的进展[J].中国法医学杂志,2012,27(5):382-385.
[3]WICHMANN D,OBBELODE F,VOGEL H,et al.Virtual autopsy as an alternative to traditional medical autopsy in the intensive care unit:a prospective cohort study[J].Annals of Internal Medicine,2012,156(1):123-130.
[4]BEDFORD P J,OESTERHELWEG L.Different conditions and strategies to utilize forensic radiology in the cities of Melbourne,Australia and Berlin,Germany[J].Forensic Science Medicine&Pathology,2013,9(3):321-326.
[5]张益鹄.法医颅脑损伤的研究进展(I)[J].中国法医学杂志,2002,17(1):51-53.
[6]张益鹄.法医颅脑损伤的研究进展(II)[J].中国法医学杂志,2002,17(2):120-123.
[7]刘宁国,杨嵩民,赵辉林,等.多层螺旋CT在交通事故损伤生物力学分析中的应用[J].法医学杂志,2010,26(6):401-405.
[8]刘宁国,邹冬华,许建荣,等.影像学技术与尸体解剖在致伤方式鉴定中的应用比较[J].法医学杂志,2009,25(4):254-259.
[9]金波,刘敏,易旭夫,等.202例猝死的法医病理学分析[J].华西医学,2006,21(2):251-254.
[10]沈忆文,赵子琴,张其英,等.猝死156例分析[J].法医学杂志,2002,18(2):92-94.
[11]GITTO L,SERINELLI S,BUSARDO F P,et al.Can postmortem computed tomography be considered an alternative for autopsy in deaths due to hemopericardium[J].Journal of Geriatric Cardiology,2014,11(4):363-367.
[12]高卫民,林羽赫,曹志鹏,等.26例肺动脉血栓栓塞的法医学分析[J].中国法医学杂志,2011,26(5):409-410.
[13]戴汝平.重视肺动脉栓塞的影像学诊断[J].中华放射学杂志,1999,33(5):293-294.
[14]FINESCHI V,BAFUNNO V,BELLO S,et al.Fatal pulmonary thromboembolism.A retrospective autopsy study:searching for genetic thrombophilias(Factor V Leiden(G1691A)and FII(G20210A)gene variants)and dating the thrombus[J].Forensic Science International,2012,214(1-3):152-158.
[15]SHIOTANI S,KOHNO M,OHASHI N,et al.Postmortem intravascular high-density fluid level(hypostasis):CT findings[J].J Comput Assist Tomogr,2002,26(6):892-893.
[16]THALI M J,YEN K,SCHWEITZER W,et al.Virtopsy,a new imaging horizon in forensic pathology:virtual autopsy by postmortem multislice computed tomography(MSCT)and magnetic resonance imaging(MRI)--a feasibility study[J].Journal of Forensic Sciences,2003,48(2):386-403.
[17]谭宗奎,陈庄洪,蔡贤华,等.交通事故与高处坠落致骨伤特点分析[J].创伤外科杂志,2004,6(2):97-99.
[18]王正国.道路交通事故伤流行病学[C]//第二届全国创伤学术交流会论文集,2008:5-7.
[19]NOZOMI S,TOMOMI M,TAKAKI I,et al.Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy[J].Forensic Science International,2014,241:112-117.
[20]TOMOMI M,TERUMI S,TAKAKI I,et al.Quantitative analysis of pulmonary pathophysiology using postmortem computed tomography with regard to the cause of death[J].Forensic Science International,2012,220(1-3):232-238.
[21]NOZOMI S,TOMOMI M,TAKAKI I,et al.Postmortem CT morphometry of great vessels with regard to the cause of death for investigating terminal circulatory status in forensic autopsy[J].International Journal of Legal Medicine,2015,129(3):551-558.
[22]TOMOMI M,NOZOMI S,TAKAKI I,et al.Cardiac dilatation index as an indicator of terminal central congestion evaluated using postmortem CT and forensic autopsy data[J].Forensic Science International,2016,263:152-157.
[23]CHRISTE A,FLACH P,ROSS S,et al.Clinical radiology and postmortem imaging(Virtopsy)are not the same:Specific and unspecific postmortem signs[J].Legal Medicine,2010,12(5):215-222.
[24]NORZAILIN A B,NOOR A S,MOHD H M,et al.The sensitivity,specificity and predictive values of post mortem computed tomography in detecting liver and splenic injury due to road traffic accident[J].Med J Malaysia,2016,71(1):1-7.
[2]汪冠三,苗春雨,王福磊,等.CT技术在法医人类学研究中应用的进展[J].中国法医学杂志,2012,27(5):382-385.
[3]WICHMANN D,OBBELODE F,VOGEL H,et al.Virtual autopsy as an alternative to traditional medical autopsy in the intensive care unit:a prospective cohort study[J].Annals of Internal Medicine,2012,156(1):123-130.
[4]BEDFORD P J,OESTERHELWEG L.Different conditions and strategies to utilize forensic radiology in the cities of Melbourne,Australia and Berlin,Germany[J].Forensic Science Medicine&Pathology,2013,9(3):321-326.
[5]张益鹄.法医颅脑损伤的研究进展(I)[J].中国法医学杂志,2002,17(1):51-53.
[6]张益鹄.法医颅脑损伤的研究进展(II)[J].中国法医学杂志,2002,17(2):120-123.
[7]刘宁国,杨嵩民,赵辉林,等.多层螺旋CT在交通事故损伤生物力学分析中的应用[J].法医学杂志,2010,26(6):401-405.
[8]刘宁国,邹冬华,许建荣,等.影像学技术与尸体解剖在致伤方式鉴定中的应用比较[J].法医学杂志,2009,25(4):254-259.
[9]金波,刘敏,易旭夫,等.202例猝死的法医病理学分析[J].华西医学,2006,21(2):251-254.
[10]沈忆文,赵子琴,张其英,等.猝死156例分析[J].法医学杂志,2002,18(2):92-94.
[11]GITTO L,SERINELLI S,BUSARDO F P,et al.Can postmortem computed tomography be considered an alternative for autopsy in deaths due to hemopericardium[J].Journal of Geriatric Cardiology,2014,11(4):363-367.
[12]高卫民,林羽赫,曹志鹏,等.26例肺动脉血栓栓塞的法医学分析[J].中国法医学杂志,2011,26(5):409-410.
[13]戴汝平.重视肺动脉栓塞的影像学诊断[J].中华放射学杂志,1999,33(5):293-294.
[14]FINESCHI V,BAFUNNO V,BELLO S,et al.Fatal pulmonary thromboembolism.A retrospective autopsy study:searching for genetic thrombophilias(Factor V Leiden(G1691A)and FII(G20210A)gene variants)and dating the thrombus[J].Forensic Science International,2012,214(1-3):152-158.
[15]SHIOTANI S,KOHNO M,OHASHI N,et al.Postmortem intravascular high-density fluid level(hypostasis):CT findings[J].J Comput Assist Tomogr,2002,26(6):892-893.
[16]THALI M J,YEN K,SCHWEITZER W,et al.Virtopsy,a new imaging horizon in forensic pathology:virtual autopsy by postmortem multislice computed tomography(MSCT)and magnetic resonance imaging(MRI)--a feasibility study[J].Journal of Forensic Sciences,2003,48(2):386-403.
[17]谭宗奎,陈庄洪,蔡贤华,等.交通事故与高处坠落致骨伤特点分析[J].创伤外科杂志,2004,6(2):97-99.
[18]王正国.道路交通事故伤流行病学[C]//第二届全国创伤学术交流会论文集,2008:5-7.
[19]NOZOMI S,TOMOMI M,TAKAKI I,et al.Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy[J].Forensic Science International,2014,241:112-117.
[20]TOMOMI M,TERUMI S,TAKAKI I,et al.Quantitative analysis of pulmonary pathophysiology using postmortem computed tomography with regard to the cause of death[J].Forensic Science International,2012,220(1-3):232-238.
[21]NOZOMI S,TOMOMI M,TAKAKI I,et al.Postmortem CT morphometry of great vessels with regard to the cause of death for investigating terminal circulatory status in forensic autopsy[J].International Journal of Legal Medicine,2015,129(3):551-558.
[22]TOMOMI M,NOZOMI S,TAKAKI I,et al.Cardiac dilatation index as an indicator of terminal central congestion evaluated using postmortem CT and forensic autopsy data[J].Forensic Science International,2016,263:152-157.
[23]CHRISTE A,FLACH P,ROSS S,et al.Clinical radiology and postmortem imaging(Virtopsy)are not the same:Specific and unspecific postmortem signs[J].Legal Medicine,2010,12(5):215-222.
[24]NORZAILIN A B,NOOR A S,MOHD H M,et al.The sensitivity,specificity and predictive values of post mortem computed tomography in detecting liver and splenic injury due to road traffic accident[J].Med J Malaysia,2016,71(1):1-7.