尸体靶向心脏冠状动脉造影在诊断冠心病猝死中的应用  

Application of Targeted Coronary Angiography in the Diagnosis of Sudden Car⁃diac Death

作　　者：赵欣[1,2] 陈志明[1,2] 刘文蕴 王博[1,2] 李泓漾 杨丽垚 滕岩 王利君 高艳斌 陈为龙[5] 张磊[3] ZHAO Xin;CHEN Zhi-ming;LIU Wen-yun;WANG Bo;LI Hong-yang;YANG Li-yao;TENG Yan;WANG Li-jun;GAO Yan-bin;CHEN Wei-long;ZHANG Lei(Department of Forensic Medicine,College of Basic Medical Sciences,Jilin University,Changchun 130021,China;Forensic Appraisal Center of Jilin University,Changchun 130021,China;Department of Radiology,The First Hospital of Jilin University,Changchun 130021,China;Judicial Identification Center of Chang-chun Public Security Bureau,Changchun 130021,China;Institute of Forensic Science,Public Security De-partment of Jilin Province,Changchun 130051,China)

机构地区：[1]吉林大学基础医学院法医学系,吉林长春130021 [2]吉林大学司法鉴定中心,吉林长春130021 [3]吉林大学第一医院放射线科,吉林长春130021 [4]长春市公安司法鉴定中心,吉林长春130021 [5]吉林省公安厅物证鉴定中心,吉林长春130051

出　　处：《法医学杂志》2023年第6期542-548,共7页Journal of Forensic Medicine

基　　金：吉林省科技厅资助项目(YDZJ202302CXJD003)。

摘　　要：目的 应用靶向心脏冠状动脉死后计算机体层成像血管造影(postmortem computed tomography angiography,PMCTA)方法 对冠状动脉狭窄进行诊断,探索其对冠心病猝死的诊断价值。方法 选用鉴定实践中的6例死亡案例,用5F猪尾型导管经股动脉入路高压注射对比剂碘海醇,获取冠状动脉影像学数据并处理分析,将冠状动脉靶向显影及冠状动脉钙化积分与常规尸体解剖、组织病理学检验结果 进行比较。结果 尸体解剖和组织病理学检验存在冠状动脉狭窄的病例在靶向心脏冠状动脉造影中均得到相似的结果 ,诊断吻合率达83.3%。靶向心脏冠状动脉造影方法 可以有效显示心脏冠状动脉病变,冠状动脉钙化积分与常规尸体解剖、组织病理学检验结果 具有一致性。结论 靶向心脏冠状动脉造影技术在冠心病猝死案件中可以作为常规尸体检验的有效辅助手段。Objective To diagnose coronary artery stenosis by using the postmortem computed tomogra‐phy angiography(PMCTA),and to explore the diagnostic value of PMCTA in sudden cardiac death.Methods Six death cases were selected,and the contrast medium iohexol was injected under high pres‐sure through femoral artery approach with 5F pigtail catheter to obtain coronary image data and then the data was analyzed.The results of targeted coronary imaging and coronary artery calcium score(CaS)were compared with the results of conventional autopsy and histopathological examination.Re‐sults The autopsy and histopathological examination of cases with coronary artery stenosis obtained similar results in targeted coronary angiography,with a diagnostic concordance rate of 83.3%.Targeted coronary angiography could effectively show coronary artery diseases,and the CaS was consistent with the results of conventional autopsy and histopathological examination.Conclusion Targeted coronary an‐giography can be used as an effective auxiliary method for conventional autopsy in cases of sudden cardiac death.

关 键 词：法医病理学 冠心病 猝死 死后计算机体层成像血管造影 冠状动脉造影 冠状动脉钙化积分 5F猪尾型导管 

分 类 号：R89[医药卫生—法医学] DF795.1[医药卫生—临床医学] D919.1[政治法律—诉讼法学]