溺死的虚拟解剖形态特征

Virtual Autopsy Morphological Features of Drowning

目的探究虚拟解剖技术在溺死尸体上获取关键证据信息的能力及其在溺死诊断中的应用价值。方法以7例溺死尸体为主要研究对象,在传统尸体解剖前行计算机断层扫描采集尸体影像数据,通过影像阅片观察特征性表现并结合虚拟测量指标,与15例非溺死尸体作为对照组进行对比分析。结果溺死者死后影像可见呼吸道较多积液、肺部呈弥漫性较均匀的毛玻璃样改变;溺死者鼻窦(上颌窦及蝶窦)内积液量为(10.24±4.70)mL,对照组量为(2.02±2.45)mL;溺死者鼻窦内积液、左心房血液、胃内容物CT均值分别为(15.91±17.20)、(52.57±9.24)、(10.33±12.81)HU,较非溺死者低(P<0.05)。结论将多项特征性影像表现与虚拟测量指标综合考虑,有助于溺死诊断,虚拟解剖技术目前可作为一种辅助溺死法医学鉴定的手段。

Objective To explore the application value of virtual autopsy to obtain key evidence infor‐mation on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning.Methods In this study,7 corpses were selected as the research objects.The image data of corpses were collected by computed tomography(CT)before conventional autopsy.The characteristics of corpses were observed through image reading,combined with virtual measurement indexes,and com‐pared with 15 non-drowned corpses.Results The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning,and ground-glass opacities in the lung.The statistical vol‐ume of fluid in the sinus(maxillary sinus and sphenoid sinus)was(10.24±4.70)mL in drowning cases and(2.02±2.45)mL in non-drowning cases.The average CT value of fluid in the sinus,left atrial blood and gastric contents in drowning cases were(15.91±17.20),(52.57±9.24)and(10.33±12.81)HU,respectively,which were lower than those in non-drowning cases(P<0.05).Conclusion The comprehensive consideration of multiple characteristic image manifestations and the virtual measure‐ment indexes are helpful to the forensic pathological diagnosis of drowning.Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.