三维螺旋CT在机械性损伤尸体检验中的价值  

The application of three-dimensional spiral CT in cadaver dead from mechanical injury

作　　者：郑剑[1,2] 刘宁国[2] 邹冬华[2] 万雷[2] 赵辉林[3] 许建荣[3] 陈忆九[2] 

机构地区：[1]复旦大学医学院法医学系,上海200032 [2]司法部司法鉴定科学技术研究所上海市法医学重点实验室,上海200063 [3]上海交通大学附属仁济医院影像科,上海200127

出　　处：《中国法医学杂志》2010年第3期150-154,共5页Chinese Journal of Forensic Medicine

基　　金：中央级科研院所社会公益研究专项(GY0706);国家自然科学基金面上项目(30872920)

摘　　要：目的应用三维螺旋CT对尸体进行检验,探索其对机械性损伤尸体的诊断能力及其优势,同时积累尸体CT检验的经验。方法对机械性损伤致死的10例尸体在解剖前行全身CT检验,随后在CT诊断的指导下进行尸体解剖,比较两者在损伤的诊断、显示效果方面的差异。结果尸体CT检验可以清晰显示身体各部位骨折及体腔内出血的三维形态特征,而且可以敏感的检查到全身各部位的积气,对于非常规解剖暴露的部位,在解剖前行CT检验可减少骨折的漏诊;对软组织内出血、器官破裂等未能形成明显X线密度差异的损伤,CT检验效果欠佳。结论对机械性损伤尸体的检验,CT有其特殊的价值,可作为尸体解剖前有效的补充,避免损伤的漏诊;对于某些无法进行尸体解剖的案件,CT检验所见可作为死亡原因判断以及致伤方式推断的参考依据。Objectives To study the diagnostic ability and superiority of three-dimensional spiral CT （3D CT） examination in corpses which died from mechanical injury,and to accumulate the experience of using 3D CT to examine corpses in forensic pathology. Methods The 10 dead bodies which died from mechanical injury were examined by 3D CT ,and then did the autopsy.We compared each other in injury diagnosis and its demonstrative effect of injury. Results The 3D CTs of hematocele in the body cavity,fractures and pneumatosis around the whole body were clearly detected and demonstrated; it＇s certainly that 3D CT can decrease the missed diagnosis of fracture in parts which were not interested in normal autopsy. When hemorrhage of soft tissue and fracture of organ was concerned,3D CT was inferior to macroscopic examination in autopsy. Conclusions 3D CT examination before autopsy is valuable in the examination of the cadaver dead from mechanical injury,and it could act as a supplemental method to avoid missing diagnosis; in some special conditions which autopsy are not allowed,the diagnosis of 3D CT can be used as referred evidence in the determination of the cause of death and the estimation of injury manner.

关 键 词：法医学 机械性损伤 三维螺旋CT 尸体检验 

分 类 号：D919.4[医药卫生—法医学]