锥形束CT在法医学中的应用与展望

Application and Prospect of CBCT in Forensic Medicine

锥形束CT是口腔颌面医学领域中具有划时代意义的三维成像设备,相对于传统螺旋CT,其具有成像分辨率高、扫描速度快、辐射剂量小、设备体积小等优点,现已被引入到法医学的科研之中。在个体识别方面,通过锥形束CT获得人体组织、器官的三维影像,可进行年龄推断、性别推断、额窦形态比对、牙齿形态比对、颅骨面貌复原等;在损伤分析方面,锥形束CT可对咬痕形态、骨折形态、枪弹伤及锐器伤进行三维重建及分析。CT技术现已成为法医学常规检查手段,而锥形束CT在头面部硬组织的三维成像中又有独特优势,其在法医学科研与实践中的价值尚未完全开发,并有可能进一步推动法齿学的深入发展。本文综述了锥形束CT在法医学中的应用,展望了其研究前景,以期为相关实践提供参考。

Cone beam computed tomography was a precise 3D imaging device designed for oral-maxillo-facial medicine. It permitted multiplane reconstructions, including coronal, sagittal and axial planes, definitely capable of improving the diagnosis and treatment of oral medicine. Compared with the traditional multi-slice computed tomography, cone beam computed tomography has the advantages of high image resolution, rapid scan, low radiation and small size. In forensic personal identification, 3D images of human tissues and organs acquired by cone beam computed tomography were valuable. Individual differences of the teeth were observed through cone beam computed tomography scanning, as well as the age related changes of dental pulp cavity. Mandibular canal images obtained by cone beam computed tomography could distinguish sexual dimorphism. Besides, the 3D reconstructions of the frontal sinus and craniofacial tissues supply a new method in anthropometry and facial reconstruction. In trauma analysis, cone beam computed tomography was an improved tool for the evaluation of bite marks, gunshot injuries, causes of fractures and stab wounds. Cone beam computed tomography could identify structural damages of hard tissues and detect the precise location of a projectile in the body. Virtual autopsy based on computed tomography has become a routine technology in the forensic practice of certain kinds of death. Cone beam computed tomography could supply higher quality images of the maxillofacial hard tissues. Progress in the research of cone beam computed tomography may improve the development of forensic odontology. In this article, some papers published in recent years were reviewed to show the present applications of cone beam computed tomography in forensic medicine, with purpose to provide new ideas for related research and practice.