MSCT鉴定高坠死亡1例分析

目的使用多层螺旋CT(multi-slice spiral computed tomography,MSCT)技术对高坠伤的损伤特征进行观察分析,并通过对高坠伤的分析和观察重建高坠过程,从而探讨MSCT在分析高坠伤案例中的应用价值。方法以真实的高坠伤案例为对象,分别运用MSCT平扫、三维重建技术对尸体进行全面检查,联合运用系统尸体解剖分析高坠伤死亡方式等特点,比较尸体解剖和MSCT在获取损伤信息方面的差异。结果MSCT扫描结合三维重建,发现全身多部位骨折以及肝破裂,尸体解剖与影像学检查结果相对应,推断死亡原因为高坠致全身多发伤。结论 MSCT在高坠伤案件致伤方式分析中可作为传统尸体解剖的补充手段。     

MSCT鉴定交通事故致死2例分析

目的使用多层螺旋CT(multi-slice spiral computed tomography,MSCT)对交通事故的致伤特征进行观察和分析,探讨MSCT在分析交通事故中的应用价值。方法以2例交通事故为对象,运用MSCT平扫、三维重建技术以及心脏穿刺造影技术对尸体进行全面检查,结合尸表检查分析交通伤形成机制等特点。结果案例1 MSCT结合心脏穿刺造影,发现死者右心破裂,死亡原因为交通事故挤压胸部致右心破裂、心脏压塞。案例2 MSCT发现左侧躯干部损伤引起脾破裂、腹腔出血,死亡原因为失血合并创伤性休克。结论 MSCT对于骨骼损伤、软组织损伤、血液改变均具有良好的观察效果,MSCT平扫结合心脏造影有助于诊断心血管系统的损伤。     

影像学技术与尸体解剖在致伤方式鉴定中的应用比较

目的探讨影像学技术在法医学死因鉴定、致伤方式分析研究中的应用范围。方法以真实高坠死亡案例为研究对象,分别运用多层螺旋CT平扫、三维重建和磁共振成像技术对尸体进行全面检查,随后即行系统尸体解剖,分别比较影像学技术与尸体解剖在关键信息和细节信息获取方面的优点和不足。结果对于损伤死亡案例,影像学技术可以收集损伤、骨折、出血等关键信息,且具有预先探知、显示非常规解剖部位微小损伤等优点,对于细节问题显示尚存在不足,某些技术的法医学应用尚需进一步磨合。结论影像学技术应用可在致伤方式鉴定中作为法医尸体解剖的指导和补充,在特定情况下可起到一定的替代作用。     

脑血管造影在法医学尸体检验中的应用

脑血管造影作为诊断脑血管疾病的"金标准",目前已经广泛地应用于临床医疗活动中,并积累了丰富的理论和实践资料,是趋于成熟的技术方法。由于因脑血管疾病引发的法医学鉴定案件较为多见,故该技术近年开始应用于法医学,显示出在法医学实践中独特而重要的应用价值。本文对脑血管造影术在法医学中的应用价值进行综述,内容包括辅助定位血管病变或损伤部位、明确出血性质、指导尸体解剖与脑组织病理取材等,并在此基础上展望了该技术在法医学中的应用前景。     

用MSCT沿鼻骨斜面多平面重组技术鉴定鼻骨线性骨折

目的探讨多层螺旋CT(MSCT)沿鼻骨斜面多平面重组(MPR)技术在鼻骨线性骨折法医学鉴定中的应用价值。方法以MSCT轴位平扫和沿鼻骨斜面多平面重组(MPR),对98例头面部外伤患者进行检查。结果 MSCT轴位平扫诊断:鼻骨正常和线性骨折(单侧或双侧)分别为29例和69例,阳性率70.4%。MSCT沿鼻骨斜面多平面重组(MPR)复诊:鼻骨正常的和线性骨折分别为19例和79例,阳性率80.6%。结论采用MSCT沿鼻骨斜面多平面重组技术可发现常规MSCT轴位平扫未能检见的鼻骨线性骨折,对法医学鉴定具有更高的应用价值。     

多层螺旋CT在交通事故损伤生物力学分析中的应用

目的探讨多层螺旋CT(multi-slice computed tomography,MSCT)及三维重建技术在交通事故损伤生物力学分析方面的应用价值。方法以真实案例为基础,通过MSCT扫描获得尸体断层影像,进行三维图像重建,结合尸体解剖、车辆勘验等结果综合分析交通事故撞击、碾压和挤压等行为方式中的生物力学过程,并与尸体解剖结果进行对比。结果 MSCT和三维重建获得了不同受力部位骨折的位置、骨折线走向以及骨内碎裂状况等原位特征,其对于骨折的精细还原优于尸体解剖。结论 MSCT和三维重建技术在原位特征的再现、图像的易操作性以及证据的保全等方面凸显优势,可对道路交通事故损伤生物力学分析起补充和引导作用。     

谈谈损伤鉴定的划分与自伤的分类

损伤在法医学检验中涉及面较广．旦复杂。既有尸体损伤，又有活体损伤；既有自杀、他杀的损伤，又有自伤、他伤的损伤；既有生前伤．又有死后伤；既有伪伤，又有真伤。从损伤的分类或命名上也不统一，特别活体损伤的性质。有的是以自杀、他伤、意外事故的鉴别为主；有的则以致伤手段为主，如造作伤；有的则以致伤目的为主，如诈伤；有的则以伤和病合并命名等。根据法医实践，作者认为法医学损伤的检验应从理论上予以理顺，据我国目前的法医检验状况，可分为尸体损伤鉴定和活体损伤鉴定两部分、前者应包括：（1）生前伤死后伤的鉴别；（2）损…     

轿车与自行车碰撞事故仿真研究及骑车者致伤特点分析

目的研究计算机仿真技术重建自行车骑行状态下交通事故发生过程,并探讨此技术在分析真实事故中骑车者人体致伤方式、特点及损伤程度上的可行性。方法通过对事故人、车痕迹鉴定和模型建立,构建相关碰撞环境并利用高性能计算机及PC-Crash软件对事故进行再现研究。结果计算机仿真技术建立的人、车模型在模拟碰撞过程中,骑车者发生的运动过程、损伤分布及损伤动力学响应结果与法医学尸表检验人体损伤部位、程度基本吻合。结论利用计算机仿真技术重建自行车骑行状态下的事故碰撞过程、分析骑车者致伤方式及提供损伤部位动力学响应参数等,对于交通伤法医学鉴定及深化交通伤机制研究具有参考价值。     

多层螺旋CT冠状动脉钙化积分在评价冠心病猝死中的应用

目的通过运用多层螺旋CT（multi—slicespiralcomputedtomography,MSCT）冠状动脉钙化积分（coronaryarterycalciumscoring．CACS）的方法．评价其在冠心痛（coronaryarterydisease,CAD）猝死案例中的法医学应用价值,为虚拟解剖鉴定CAD猝死探索有效手段。方法收集9例进行法医学鉴定的心源性猝死案例．尸体解剖前均进行MSCT扫描。通过Agatston’s法对每例冠状动脉钙化程度进行定量分析,并计算CACS,钙化积分〉400作为存在CAD的评判标准,并与尸体解剖结果比较。结果经尸体解剖证实CAD猝死的9例案例中仅有2例钙化积分〉400,CACS对CAD的预测率仅为22．2％。MSCT检查与系统尸体解剖均发现CAD猝死案例中普遍存在不同程度肺水肿改变,冠状动脉左前降支较其他分支发生管腔狭窄的发病率高。结论运用MSCT并结合计算CACS可对CAD猝死案例中冠状动脉钙化明显的进行检测,而钙化不明显的需要辅以如尸体血管造影等其他技术。     

汽车碰撞中乘员损伤成因分析与计算机仿真研究

目的运用计算机仿真技术模拟汽车碰撞过程,为法医学鉴定及交通事故处理提供参考依据。方法通过对汽车碰撞中乘员损伤成因分析及车辆痕迹检验,建立有效的人体、车辆仿真模型,利用动量冲量法与多刚体动力学结合仿真求解乘员运动模式,客观再现乘员交通伤特点。结果计算机仿真汽车碰撞过程中,人体模型上碰撞部位的分布符合法医学检验所得结果。结论计算机仿真求解乘员交通伤的方法在法医学鉴定和事故责任认定中具有参考价值。     

Visualization and quantification of air embolism structure by processing postmortem MSCT data

Venous air embolism (VAE) is an often occurring forensic finding in cases of injury to the head and neck. Whenever found, it has to be appraised in its relation to the cause of death. While visualization and quantification is difficult at traditional autopsy, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) offer a new potential in the diagnosis of VAE. This paper reports the findings of VAE in four cases of massive head injury examined postmortem by Multislice Computed Tomography (MSCT) prior to autopsy. MSCT data of the thorax were processed using 3D air structure reconstruction software to visualize air embolism within the vascular system. Quantification of VAE was done by multiplying air containing areas on axial 2D images by their reconstruction intervals and then by summarizing the air volumes. Excellent 3D visualization of the air within the vascular system was obtained in all cases, and the intravascular gas volume was quantified.     

Image-guided virtual autopsy findings of gunshot victims performed with multi-slice computed tomography and magnetic resonance imaging and subsequent correlation between radiology and autopsy findings

Because the use of radiology in modern forensic medicine has been, until today, mostly restricted to conventional X-rays, which reduces a 3D body to a 2D projection, a detailed 3D documentation of a gunshot's wound ballistic effects was not possible. The aim of our study was to evaluate whether the progress in imaging techniques over the last years has made it possible to establish an observer-independent and reproducible forensic assessment using multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) technologies for the documentation and analysis of gunshot wounds. The bodies of eight gunshot victims were scanned by MSCT and by MRI; the data of these imaging techniques were post-processed on a workstation, interpreted and subsequently correlated with the findings of classical autopsy. With the spiral CT and MRI examinations and the subsequent 2D multi-planar reformation (MPR) and 3D shaded surface display (SSD) reconstruction, the entire gunshot-created complex skull fractures and brain injuries (such as wound channels and deeply-driven bone splinters) could be documented in complete and graphic detail. CT and MRI also documented vital reaction to the gunshot by demonstrating air emboli in the heart and blood vessels and the classic pattern of blood aspiration to the lung. Gunshot residues deposited within and under the skin were visible. In conclusion, we think that the radiological methods of MSCT and MRI have the potential to become a routine "virtual autopsy" tool in the future. Bullets and relevant histological samples from specific sites then might be won in image-guided minimally invasive fashion via percutaneous biopsy. The rapid application of developing radiological methods may lead to new horizons in forensic documentation and intravital as well as postmortem examination.     

High-quality Digital 3D Reconstruction of Microscopic Findings in Forensic Pathology: The Terminal Pathway of a Heart Stab Wound*

High-quality digital three-dimensional (3D) reconstructions of microscopic findings have been used in anatomical and histopathologic research, but their use in forensic pathology may also be of interest. This paper presents an application of these methods to better characterize the pathway of a stab wound of the anterior surface of the heart in a case of suicide. A portion of the heart wall including the stab wound was serially sectioned for microscopic analysis along the full extent of the wound. Histologic sections were digitally acquired, and a 3D reconstruction was created with ImageJ software for 3D computer graphics. This showed a full-thickness wound path extending to the endocardial surface of the left ventricle, curvilinear in appearance. After correction for shrinkage, 3D reconstruction allowed estimation of the dimensions of the myocardial injury and comparison of the appearance of the wound with the suspected knife used. The curvilinear appearance was considered to reflect injury during myocardial contraction. Complete microscopic sectioning and 3D reconstruction may allow virtual sectioning through various orientations and also provide useful forensic information for selected injuries.     

Post-mortem forensic neuroimaging: correlation of MSCT and MRI findings with autopsy results

Multislice-computed tomography (MSCT) and magnetic resonance imaging (MRI) are increasingly used for forensic purposes. Based on broad experience in clinical neuroimaging, post-mortem MSCT and MRI were performed in 57 forensic cases with the goal to evaluate the radiological methods concerning their usability for forensic head and brain examination. An experienced clinical radiologist evaluated the imaging data. The results were compared to the autopsy findings that served as the gold standard with regard to common forensic neurotrauma findings such as skull fractures, soft tissue lesions of the scalp, various forms of intracranial hemorrhage or signs of increased brain pressure. The sensitivity of the imaging methods ranged from 100% (e.g., heat-induced alterations, intracranial gas) to zero (e.g., mediobasal impression marks as a sign of increased brain pressure, plaques jaunes). The agreement between MRI and CT was 69%. The radiological methods prevalently failed in the detection of lesions smaller than 3mm of size, whereas they were generally satisfactory concerning the evaluation of intracranial hemorrhage. Due to its advanced 2D and 3D post-processing possibilities, CT in particular possessed certain advantages in comparison with autopsy with regard to forensic reconstruction. MRI showed forensically relevant findings not seen during autopsy in several cases. The partly limited sensitivity of imaging that was observed in this retrospective study was based on several factors: besides general technical limitations it became apparent that clinical radiologists require a sound basic forensic background in order to detect specific signs. Focused teaching sessions will be essential to improve the outcome in future examinations. On the other hand, the autopsy protocols should be further standardized to allow an exact comparison of imaging and autopsy data. In consideration of these facts, MRI and CT have the power to play an important role in future forensic neuropathological examination.     

基于3D激光扫描、多刚体重建和遗传算法优化的车-人碰撞事故再现模拟与损伤分析

目的利用3D激光扫描技术,结合多刚体动力学和遗传算法优化对一起汽车与自行车及其骑车人碰撞的交通事故进行再现模拟与损伤分析,为法医学死因鉴定提供生物力学依据。方法利用3D激光扫描技术对肇事汽车进行测量,根据测量数据建立人-自行车-汽车多刚体模型,并设置优化变量的取值范围,利用多目标遗传算法,带精英策略的快速非支配排序遗传算法求最优近似解,并与事故现场附近监控视频记录进行比较。结果事故车辆激光扫描重建结果良好,通过遗传算法优化收敛所获得的最优近似解中的假人、自行车、汽车的动力学行为与监控视频中所记录的三者动力学行为相符合,假人的损伤参数也与事故中骑车人的损伤情况及部位相一致。结论利用3D激光扫描技术,结合多刚体动力学和遗传算法优化可以对人-自行车-汽车碰撞前的运动状态、碰撞致伤过程进行重建,并对受害者的损伤进行力学分析,在交通事故受害人致伤方式鉴定及死因分析中具有应用价值。     

Virtopsy,a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI)--a feasibility study

Using postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI), 40 forensic cases were examined and findings were verified by subsequent autopsy. Results were classified as follows: (I) cause of death, (II) relevant traumatological and pathological findings, (III) vital reactions, (IV) reconstruction of injuries, (V) visualization. In these 40 forensic cases, 47 partly combined causes of death were diagnosed at autopsy, 26 (55%) causes of death were found independently using only radiological image data. Radiology was superior to autopsy in revealing certain cases of cranial, skeletal, or tissue trauma. Some forensic vital reactions were diagnosed equally well or better using MSCT/MRI. Radiological imaging techniques are particularly beneficial for reconstruction and visualization of forensic cases, including the opportunity to use the data for expert witness reports, teaching, quality control, and telemedical consultation. These preliminary results, based on the concept of "virtopsy," are promising enough to introduce and evaluate these radiological techniques in forensic medicine.     

多层螺旋CT检查在尸体颈椎损伤中的应用

对需要在尸体检验时进行颈椎多层螺旋CT(MSCT)检查的情形进行讨论,研究利用MSCT对疑有颈椎损伤的尸体进行颈椎检查的方法,并对一例疑似颈椎损伤尸体的颈椎提取后进行MSCT检查。发现对疑似有颈椎骨折尸体提取颈椎进行MSCT检查,可以快速精确地显示颈椎的细微骨折及骨折的空间分布,从而推断致伤方式。解决了传统尸检中费时费力,容易漏诊和误诊的问题。     

'Morphological imprint': determination of the injury-causing weapon from the wound morphology using forensic 3D/CAD-supported photogrammetry

Forensic three-dimensional/computer aided design (CAD)-supported photogrammetry (FPHG) plays an important role in the field of the documentation of forensic relevant injuries; particularly so when a detailed, 3D reconstruction is necessary. This is demonstrated in the case of a patterned blunt injury to the face of a victim, which injury was subsequently proven by FPHG to have been caused by a blow from the muzzle of a soft air gun.The objects to be evaluated had to be series photographed in order to be evaluated virtually on the computer. These photo series were then analyzed with the RolleiMetric system. This system measures and calculates the spatial location of distinctive points on the objects' surfaces, and creates 3D data models of the objects. In a 3D/CAD program, the "virtual 3D model of the injury" is then compared against the "virtual 3D model of the possible injury-causing instrument".The validation of FPHG, as shown by the 3D match between certain characteristics of the muzzle form and the facial injury, demonstrates how this 3D method can be used for patterned wound documentation and analysis.     

Haptics in forensics: The possibilities and advantages in using the haptic device for reconstruction approaches in forensic science

Non-invasive documentation methods such as surface scanning and radiological imaging are gaining in importance in the forensic field. These three-dimensional technologies provide digital 3D data, which are processed and handled in the computer. However, the sense of touch gets lost using the virtual approach. The haptic device enables the use of the sense of touch to handle and feel digital 3D data. The multifunctional application of a haptic device for forensic approaches is evaluated and illustrated in three different cases: the representation of bone fractures of the lower extremities, by traffic accidents, in a non-invasive manner; the comparison of bone injuries with the presumed injury-inflicting instrument; and in a gunshot case, the identification of the gun by the muzzle imprint, and the reconstruction of the holding position of the gun.The 3D models of the bones are generated from the Computed Tomography (CT) images. The 3D models of the exterior injuries, the injury-inflicting tools and the bone injuries, where a higher resolution is necessary, are created by the optical surface scan.The haptic device is used in combination with the software FreeForm Modelling Plus™ for touching the surface of the 3D models to feel the minute injuries and the surface of tools, to reposition displaced bone parts and to compare an injury-causing instrument with an injury.The repositioning of 3D models in a reconstruction is easier, faster and more precisely executed by means of using the sense of touch and with the user-friendly movement in the 3D space. For representation purposes, the fracture lines of bones are coloured. This work demonstrates that the haptic device is a suitable and efficient application in forensic science. The haptic device offers a new way in the handling of digital data in the virtual 3D space.