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。     

CT、MRI在弥漫性轴索损伤法医学鉴定中应用价值分析

目的探讨CT和MRI检查方法在弥漫性轴索损伤(diffuse axonal injury,DAI)法医学鉴定中的应用价值。方法收集26例CT和MRI影像资料齐全的DAI鉴定资料进行回顾性分析,比较CT和MRI两种方法对DAI病灶检出率的差异,分析DAI病灶检出数量与法医学鉴定结果之间的关系。结果 26例经MRI检出DAI病灶787个,经CT检出DAI病灶32个,MRI对DAI病灶的敏感度显著高于CT(P0.01)具有统计学意义。26例DAI鉴定的伤残等级数值与影像学检查发现的病灶数量之间存在负相关(r=-0.908,P0.01)。结论 MRI检查对DAI病灶的检出率较CT检查具有明显优势,可为DAI诊断提供更为准确的依据,在法医临床学鉴定中具有重要的应用价值。     

CT在法医人类学中的应用与展望

计算机X线断层摄影术具有分辨率高、成像清晰、可进行三维重建等优点,对骨骼和牙齿的成像效果较好。近十年来,国外有学者将其用于推断年龄和身高,判定种族和性别,在相关文献中介绍了有关的研究方法和数据,并对这些方法和数据在法医人类学个体识别中的应用价值进行了客观的评估。笔者对近几年发表的部分文献进行综述,希望能够为法医人类学科研和办案提供新的方法和思路。     

CT测量在眶内壁骨折损伤程度鉴定中的应用

目的 利用CT测量眶内壁骨折案件中伤者眶容积扩大率及眶内壁骨质缺损面积,探讨两种CT测量值用于评估眶内壁骨折范围的可行性.方法 选取20例无眼眶骨折案件作为对照组,使用CT测量双侧眶容积,并比较两例是否存在差异.选取本院2018-2020年间受理的眶内壁骨折案件39例作为实验组,并根据鉴定意见分为轻伤组与轻微伤组.分别...     

CT‐Guided,Minimally Invasive,Postmortem Needle Biopsy Using the B‐Rob II Needle‐Positioning Robot

CT‐guided, minimally invasive needle biopsy techniques can be used to retrieve tissue or body fluid samples for histologic tissue diagnoses in forensic investigations. The purpose of this study was an evaluation of CT‐guided needle‐positioning robot B‐Rob II. To operate under CT guidance, we adopted the B‐Rob II robotic needle placement system and its workflow. The accuracy and speed of the procedure were tested on a gelatin phantom in a series of 21 biopsies. We achieved an average needle placement accuracy of 1.8 mm (±1.1 mm) using robotic assistance. The procedure required an average of 2 min 21 s. The needle placement accuracy for minimally invasive needle biopsies using the B‐Rob II biopsy robot is sufficiently accurate and fast for forensic postmortem examinations of focal organ changes. Further tests will be performed to test the feasibility of the robot for performing biopsies of focal organ changes in human bodies.     

静脉气体栓塞的研究进展

气体栓塞是一种较多见而又威胁生命的医疗操作并发症,在法医学实践中也时有所遇,但易被检验者所忽略;也常因尸体放置较久而给法医学检验和鉴定带来困难。在此综述了静脉气体栓塞的病因、病理生理变化、临床表现及诊断和法医学鉴定的意义及注意事项,认为超声心动图、CT和MRI等现代成像技术在气体栓塞的临床诊断和法医学鉴定中有积极的辅助作用。     

不同部位颅脑摔跌伤的特征分析68例

目的探讨不同受力部位颅脑摔跌伤后损伤程度和特征差异。方法收集摔跌所致颅脑损伤68例,根据案情、受伤过程、临床体征、CT影像资料将受伤部位分为颅前部、颅侧部、颅后部;损伤类型分为颅骨骨折、硬脑膜外血肿、硬脑膜下血肿和脑挫裂伤;损伤数量分为单一和多发伤;颅骨骨折分为受力点骨折和非受力点骨折;脑挫裂伤分为冲击伤、对冲伤等。运用非参数统计χ2检验比较其频数分布。结果不同摔跌部位颅骨骨折和颅脑损伤程度存在明显差异(P0.05),颅后部摔跌颅骨骨折远离受力点多见,多发伤为主,而颅前部、颅侧部受力点骨折多见,单处损伤多见;颅后部、颅侧部摔跌后脑挫裂伤发生率高,以对冲部位多见,颅前部摔跌后脑挫裂伤发生率低,冲击伤亦多见。结论摔跌部位不同颅脑损伤程度和特征存在差异,CT检查资料有助于损伤机制推断。     

骨骼CT三维重建图像性别判定和年龄推断研究

目的通过计算骨骼计算机断层扫描(Computed Tomography,CT)三维重建图像判定性别和推断年龄的准确率,评价利用骨骼CT三维重建图像判定性别和推断年龄的可行性。方法将法医人类学教材中性别判定和年龄推断的方法应用于539例骨骼CT三维重建图像样本,判定245例骨盆的性别,推断100例男性耻骨联合、100例男性胸骨和94例男性锁骨的年龄,计算准确率。结果骨盆性别判定准确率为98.4%,耻骨下角和坐骨大切迹是区分性别最好的两项指标。男性耻骨联合、胸骨、锁骨的年龄推断准确率在45%以上,其中锁骨双侧方程准确率最高为77%。结论利用骨骼CT三维重建图像判定性别和推断年龄具有可行性。使用大体标本建立的骨盆形态学性别判定方法可直接应用于骨骼CT三维重建图像。使用大体标本建立的男性耻骨联合、胸骨、锁骨形态学年龄推断指标、分级和评分标准以及方程需要修改和补充。     

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.     

多层螺旋CT、普通CT和X线在骨折法医学鉴定中的应用

目的比较多层螺旋CT（MSCT）、普通CT与X线3种检查法,评价它们在骨折法医鉴定中的应用价值。方法对366例受检者（已接受其他影像学检查）行MSCT薄层扫描并行SSD,透明化X线模拟投影和MPR处理。统计分析MSCT、CT常规与X线检查在各部位骨折中的诊断正确率和漏、误诊率并行χ2检验。结果鼻骨、肋骨、四肢及关节、眶骨、颅骨骨折MSCT诊断正确率明显高于普通CT或X线（P〈0.01）。MSCT与普通CT对脊柱骨折的诊断正确率无统计学差异（P〉0.05）。MSCT、普通CT与X线的总体诊断正确率分别为99.45%、70.27%和59.17%。常规CT、X线与MSCT诊断结果间存在显著统计学差异（P〈0.001）。结论MSCT对骨折的显示更准确,可作为法医鉴定的重要辅助检查手段。