清肝方治疗26例脂肪肝的CT疗效评价

目的 采用CT定量测定作为主要诊断与疗效评价指标,观察清肝方治疗脂肪肝的疗效。方法 将60例符合诊断标准的脂肪肝患者随机分为治疗组和对照组,对照组30例采取调整饮食及体育锻炼等方法进行基础治疗,治疗组30例在对照组治疗的基础上,给予中药清肝方随证加减治疗,两组疗程均为12周。观察两组患者治疗前后症状、体征、肝功能、血脂、空腹血糖、肝/脾CT值比值的变化。结果 治疗组和对照组分别脱失4、3例。治疗组总有效率显著高于对照组(84.61% vs 51.85%,P<0.05);治疗后两组血清丙氨酸氨基转移酶水平显著降低（P<0.05）,治疗组在降低总胆固醇、低密度脂蛋白,升高肝脏CT值和肝/脾CT值比值方面显著优于对照组(P<0.05,或P<0.01)。结论 清肝方治疗脂肪肝疗效显著,肝/脾CT值比值可以更直接、客观地判定临床疗效。     

13例外伤性脑脊液鼻漏的CT诊断及法医学意义

外伤性鼻旁窦单纯性骨折法医学损伤程度评定为轻伤,如果并发脑脊液鼻漏长期不愈则评定为重伤。临床CT诊断中,鼻旁窦骨折并发脑脊液鼻漏与鼻旁窦骨折并发窦腔积血及窦腔炎性积液极易混淆。因此,正确诊断鼻旁窦骨折并发脑脊液鼻漏具有法医学意义[1]。作者对13例临床确诊为外伤性脑脊液鼻漏患者的CT检查进行法医学分析,现报道如下。1对象与方法1.1对象临床确诊为外伤性脑脊液鼻漏的患者13例,男9例,女4例,平均年龄24.3岁。车祸伤11例,拳击伤2例。全部病例均在受伤后5h内进行CT检查,其中11例诊断为鼻旁窦骨折并发窦腔积血,2例诊断为鼻旁窦骨折…     

头颅CT片同一认定研究

目的探寻头颅CT片同一认定的方法。方法分别计算同一被检查者不同次头颅CT片指标差值和不同被检查者头颅CT片指标差值,再应用二分类logistic回归分析相同被检查者和不同被检查者指标差值,建立头颅CT片同一认定回归方程。结果建立头颅CT片同一认定方程46个。结论通过头颅CT片测量可以进行有效同一认定。     

An accuracy assessment of forensic computerized facial reconstruction employing cone-beam computed tomography from live subjects

The utilization of 3D computerized systems has allowed more effective procedures for forensic facial reconstruction. Three 3D computerized facial reconstructions were produced using skull models from live adult Korean subjects to assess facial morphology prediction accuracy. The 3D skeletal and facial data were recorded from the subjects in an upright position using a cone-beam CT scanner. Shell-to-shell deviation maps were created using 3D surface comparison software, and the deviation errors between the reconstructed and target faces were measured. Results showed that 54%, 65%, and 77% of the three facial reconstruction surfaces had <2.5 mm of error when compared to the relevant target face. The average error for each reconstruction was -0.46 mm (SD = 2.81) for A, -0.31 mm (SD = 2.40) for B, and -0.49 mm (SD = 2.16) for C. The facial features of the reconstructions demonstrated good levels of accuracy compared to the target faces.     

中国汉族成人颅骨CT片同一认定方法的研究

目的建立对中国汉族成人颅骨CT片进行同一认定的方法。方法按照纳入标准收集100例中国汉族成人颅骨CT片，对确定的识别指标进行观察和测量，对各指标的观测结果进行分类编码，然后按观测顺序编制特异的12位颅骨CT片识别编码。运用SPSS13．0统计学软件对所得数据进行各指标年龄和性别差异的统计学分析，利用个人识别能力公式计算单个指标和总体指标的个人识别能力。结果12项识别指标中有6个指标存在男女性别差异；12项指标累计个人识别能力可达到99．9997997％。结论本文确定中国汉族成人颅骨CT片12项观测指标，利用指标分类编码法可进行中国汉族成人颅骨CT片的同一认定。     

多层螺旋CT诊断颅底骨折及其法医学应用价值

目的 比较多层螺旋CT三种重建方法在显示颅底骨折方面的差异,探讨其在法医学鉴定中的应用价值。方法 对40例颅脑外伤后怀疑颅底骨折的伤者进行多层螺旋CT扫描,然后将容积数据输入工作站进行横断面重建、多平面重建(MPR)和三维重建,三维重建采用表面显示法(SSD)。结果 24例颅前窝骨折,其中横断面显示骨折9例,MPR显示骨折24例,SSD显示9例;3组比较有显著性差异(P<0.001)。24例颅中窝骨折,横断面显示骨折15例,MPR显示骨折24例,SSD显示骨折4例;3组比较有显著性差异(P<0.001)。横断面重建和MPR均显示颅后窝骨折3例,两者无明显差异,SSD有1例显示。结论 SSD成像直观立体地显示了骨折的形态、走行、空间位置等情况,但对细小骨折显示不佳;多层螺旋CT检查可用于颅底骨折的法医学鉴定。     

国内外液态爆炸物安全检查技术和设备的发展

液态爆炸物具有制造简易、不易识别、威力巨大、易于引爆等特点,这些特点增加了液态爆炸物安全检查的难度。液态爆炸物的安全检查分为探测、防护和处置三个环节。针对探测环节,文章综述了国内外主要使用的液态爆炸物探测技术及其特点,介绍了有代表性的技术产品,探讨了液态爆炸物探测技术的发展趋势,最后,对我国液态爆炸物安全检查行业的技术发展提出了几点建议。     

A Pilot Study Comparing Postmortem and Antemortem CT for the Identification of Unknowns: Could a Forensic Pathologist Do It?

Forensic pathologists are commonly tasked with identifying human remains. Although DNA analysis remains the gold standard in identification, time and cost make it particularly prohibitive. Radiological examination, more specifically analog imaging, is more cost-effective and has been widely used in the medical examiner setting as a means of identification. In the United States, CT imaging is a fairly new imaging modality in the forensic setting, but in more recent years, offices are acquiring CT scans or collaborating with local hospitals to utilize the technology. To broaden the spectrum of potential identifying characteristics, we collected 20 cases with antemortem and postmortem CT images. The results were qualitatively assessed by a forensic pathologist and a nonmedically trained intern, and all cases were correctly identified. This study demonstrates that identification of human remains using visual comparison could be performed with ease by a forensic pathologist with limited CT experience.     

Quantitative Analysis of the Morphological Changes of the Pubic Symphyseal Face and the Auricular Surface and Implications for Age at Death Estimation

Age estimation methods are often based on the age‐related morphological changes of the auricular surface and the pubic bone. In this study, a mathematical approach to quantify these changes has been tested analyzing the curvature variation on 3D models from CT and laser scans. The sample consisted of the 24 Suchey–Brooks (SB) pubic bone casts, 19 auricular surfaces from the Buckberry and Chamberlain (BC) “recording kit” and 98 pelvic bones from the Terry Collection (Smithsonian Institution). Strong and moderate correlations between phases and curvature were found in SB casts (ρ 0.60–0.93) and BC “recording kit” (ρ 0.47–0.75), moderate and weak correlations in the Terry Collection bones (pubic bones: ρ 0.29–0.51, auricular surfaces: ρ 0.33–0.50) but associated with large individual variability and overlap of curvature values between adjacent decades. The new procedure, requiring no expert judgment from the operator, achieved similar correlations that can be found in the classic methods.     

第12胸椎三维重建图像性别判定研究

目的考察计算机断层扫描(CT)技术测量中国汉族第12胸椎判定性别的效果,探索CT技术在法医人类学人体骨骼测量研究中应用的可行性。方法确定11项径线指标测量第12胸椎多层面重组(MPR)三维重建图像,剔除不稳定指标后计算四项比值指标,统计各项指标的数据考察CT测量第12胸椎判定性别的效果。结果剔除两次测量结果不稳定的三项指标后的12项指标性别差异显著,建立了7个性别判定方程,综合判别率在80.0%~91.6%,仅含椎体指标的方程性别判别率最高达91.6%。结论中国汉族人第12胸椎形态学测量指标具有性别差异,CT技术可以准确测量骨骼,对法医人类学人体骨骼测量研究具有应用价值。