新西兰白兔死亡后颅脑CT检查与死亡时间关系的研究

目的采用CT扫描动态观察新西兰白兔死亡后脑组织变化,建立利用CT值、脑组织/颅腔面积比,推断死亡时间(PM I)的研究方法。方法通过耳缘静脉注射空气,建立新西兰白兔死亡模型;于死亡后0~120h,运用CT进行头颅平描;选取颅顶面层测定脑组织CT值、脑组织/颅腔面积比。结果死亡后兔脑组织CT值呈双峰样上升、脑组织/颅腔面积比呈不断下降趋势;建立与死亡时间的回归方程:CT值=47.4780-0.1768T+0.0049T2(T/h,CT值/HU)、面积比=99.7368+0.3098T-0.0118T2/100(T/h)。结论CT扫描检查可准确显示兔脑的死后变化;脑组织消失之前,综合运用CT检查指标可用于准确推断死亡时间。     

Reproducibility of facial soft tissue thicknesses for craniofacial reconstruction using cone-beam CT images

The purpose of this study was to evaluate the reproducibility of the soft tissue (ST) thicknesses at 31 landmarks using the cone-beam computed tomography (CBCT) images obtained from 20 adult subjects. Four observers carried out ST thickness measurements using Skull Measure software, and the inter- and intra-observer error rates were evaluated. Only five of 31 landmarks showed significant differences in recorded ST thickness between the observers. When excluding inexperienced observers, only one landmark showed a significant difference between the observers. Regarding the intra-observer reproducibility, the ST thickness measurements at three landmarks showed low correlation coefficients. The results of this study indicate that CBCT images can be used to measure ST thickness with high reproducibility. However, some landmarks need to be redefined to reliably measure ST thickness on CBCT images.     

根据颈椎CT片特征指标进行同一认定的研究

目的选择颈椎CT片上的特征指标,建立逐步回归方程,探讨其在法医学同一认定中的应用价值。方法收集130名被检查者颈椎CT片各1张,70名被检查者不同次颈椎CT影像片各2张。选择并测量颈椎CT片上的13项指标值,分别计算被检查者随机分组后相同测量指标的组间差值,以及同一人不同次测量指标间的差值,运用二分类logistic逐步回归分析,建立各项指标的一元回归方程和多项指标的多元回归方程,并对方程进行盲测检验。结果建立的13个一元方程中同一认定的准确率在69.0%~90.4%之间;建立的4个多元回归方程的准确率在90.4%~96.7%之间,盲测准确率为100%。结论本文在CT片上选择的13项特征指标可以用于同一认定,使用时应尽可能选用多元指标以得到更准确的结果。     

Cardiac Ventricular Laceration Due to Child Abuse: Abusive Ventricular Laceration

Traumatic cardiac ventricular ruptures in children are rare. Only a single case of left ventricular rupture due to child abuse has been reported. We report a child who sustained a fatal left ventricular apical rupture. It appeared to have resulted from hydrostatic forces resulting from abusive blunt thoracic injury. That he was being abused was previously missed when he was presented to the emergency department with facial pyoderma. It was not noted that he also had lip and oral mucosal injury, sites not affected by staph toxins. As a result, his underlying, abusive and secondarily infected, facial flow type scald burn was not appreciated. Within a week thereafter his fatal injury occurred, accompanied by extensive and obvious associated abusive injuries. Postmortem high‐detail whole body computed tomography scanning aided the autopsy. Although rare, ventricular rupture from abusive blunt thoracic injury can occur.     

Evaluation of maxillary sinus dimensions in gender determination using helical CT scanning

Gender determination is an important step in identification in forensic medicine. CT measurements of maxillary sinuses may be useful to support gender identification. This study was undertaken to study the accuracy and reliability of maxillary sinus dimensions measurement in gender classification through the use of reconstructed helical CT images. Eighty-eight patients (43 men and 45 women) with age range from 20 to 49 years were selected in this study. The width, length, and height of the maxillary sinuses in addition to the total distance across both sinuses were measured. Data were subjected to discriminant analysis for gender using multiple regression analysis. Maxillary sinus height was the best discriminant parameter that could be used to study sexual dimorphism with an overall accuracy of 71.6%. Using multivariate analysis, 74.4% of male sinuses and 73.3% of female sinuses were sexed correctly. The overall percentage for sexing maxillary sinuses correctly was 73.9%. It can be concluded that reconstructed CT image can provide valuable measurements for maxillary sinuses and could be used for sexing when other methods of sexing are not conclusive.     

4种影像学检查方法应用于肩关节损伤法医学鉴定的比较

目的 评价X线、CT、MRI及CT气-碘双对比造影4种方法在肩关节损伤法医学鉴定中的应用价值.方法通过对肩关节损伤患者行X线摄片、CT扫描、MRI成像与CT气-碘双对比造影检查,观察、分析4种方法所得的影像学资料.结果 X线摄片对骨折的诊断率为52.8%,对软组织损伤的诊断率为0%;CT对骨折的诊断率为72.0%.对软...     

Machinery‐Related Deaths: Relevance of Workplace Investigation and Antemortem Radiological Data in Reconstructing the Fatality

Abstract: Machinery‐related fatalities are one of the leading causes of traumatic occupational deaths. In our report, we present the case of a 40‐year‐old male who suffered a severe head trauma while working in a cut‐foam industry and died despite an early craniectomy. The radiological reconstruction of the skull based on preoperative computed tomography scans disclosed a large depressed conical fracture of the left parietal bone. The 3D‐reconstruction of the work area, combined with a fit‐matching analysis between the machinery and the depressed skull fracture allowed us to conclude that the head was crushed between the sliding bar of the cutting device and the metallic protuberance on the opposite side. The case underlines the importance of a detailed workplace investigation and of a thorough evaluation of all circumstantial, clinical, radiological, and autopsy data in the reconstruction of machinery‐related fatalities to identify any possible legal responsibilities of the worker and/or the employer.     

Ossification Degrees of Cranial Sutures Determined with Flat‐Panel Computed Tomography: Narrowing the Age Estimate with Extrema

Abstract: Since Broca’s time (1824–1880), ossification of the neurocranial sutures has been used as a characteristic of age. Current approaches include the visual macroscopic examination of ecto and endocranial sutures. The evaluation of the cross‐section of sutures usually necessitates the destruction of the neurocranium. In a nondestructive alternative approach that was tested within the context of the “Digital Forensic Osteology” project that ran in cooperation with the Virtopsy^®‐Project, it emerged that the resolution of conventional multi‐slice computed tomography data sets was not high enough to image sutures. Thus for the experiments presented here, the eXplore Locus Ultra flat‐panel computed tomography scanner from GE Healthcare was used. Calottes were scanned during autopsy and then immediately returned to the corpse. So far, the skullcaps of 221 individuals have been scanned. The cross‐sections of 14 suture segments could be assessed for seven previously defined stages of ossification. In a converse step, the 14 highest and lowest age estimate values corresponding to the individual stages of suture closure found were estimated for each calotte. The obtained ranges narrowing down the age estimate were evaluated with statistics. A mean value of 43.31 years for the range of narrowed age estimates shows that this method can be a useful aid in estimating age. The results of intra‐ and inter‐observer tests showed good overall agreement between the findings of three observers. This method is suitable for a nondestructive age estimation and can be used for the entire calotte.     

Discrete Traits of the Sternum and Ribs: A Useful Contribution to Identification in Forensic Anthropology and Medicine

During forensic anthropological investigation, biological profile is determined by age, sex, ancestry, and stature. However, several individuals may share the same profile. Observation of discrete traits can yield useful information and contribute to identification. This research establishes the frequency of discrete traits of the sternum and ribs in a modern population in southern France, using 500 computer tomography (CT) scans of individuals aged 15–60 years. Only discrete traits with a frequency lower than 10% according to the literature were considered, a total of eight traits. All scans examined were three‐dimensional (3D) volume renderings from DICOM images. In our population, the frequency of all the discrete traits was lower than 5%. None were associated with sex or age, with the exception of a single trait, the end of the xiphoid process. Our findings can usefully be applied for identification purposes in forensic anthropology and medicine.     

经皮穿刺CT气-碘造影在肩关节损伤鉴定的应用

目的探讨经皮穿刺CT气-碘双对比造影在肩关节损伤法医学鉴定中的应用价值。方法10例被鉴定人均在CT介入引导下行经皮伤侧肩关节囊穿刺,分别注入稀释的Omnipaque和过滤空气适量,在全身CT机上行肩关节连续扫描,所获数据行轴位和准冠状位重建。结果被鉴定人均无明显不适主诉;CT气-碘双对比造影可显示肩关节囊有不同程度的损伤。结论经皮穿刺CT气-碘双对比造影有助于肩关节损伤的诊断,并为法医学鉴定提供重要的影像学依据。