离体心脏冠状动脉造影术及其法医学应用

目的应用冠状动脉造影技术对离体心脏进行检查,以便更准确地发现冠状动脉病变的位置、性质和程度,提高综合评价心血管疾病的能力。方法提取10例不同死因的新鲜离体心脏,用指环注射器对离体心脏加压注射硫酸钡造影剂,在Xper FD20血管造影机下显影,获取图片及影像资料,应用造影机附带软件对所获得的影像资料进行三维成像处理。取冠状动脉组织HE染色,镜下观察,并与造影结果对比。结果 10例检材经造影获得的影像学资料,其中8例冠状动脉主支及各分支未发现狭窄,2例检材发现存在Ⅲ级、Ⅳ级冠状动脉狭窄。与冠状动脉组织HE染色结果一致,二者相互印证。结论离体冠状动脉造影技术对于冠状动脉狭窄准确分级、血管畸形及微小病变的检验有其独特的优越性,可为尸体检验病理取材时微小病变的定位提供参考,为鉴定意见提供依据。

Coronary Angiography in Isolated Hearts and Its Forensic Application

ObjectiveTo check the isolated heart by coronary angiography to discover the location, na-ture and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease.MethodsTen fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimen-sional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results.ResultsThe imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳcoronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed. ConclusionIsolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.