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虚拟解剖技术在医疗纠纷尸体检验中的应用
引用本文:金馨,赵建新,姚艺,黄俊杰,张峰,李兴彪,叶光华,范琰琰,黄定品,夏能志,邹冬华,刘宁国,喻林升. 虚拟解剖技术在医疗纠纷尸体检验中的应用[J]. 法医学杂志, 2020, 0(1): 72-76
作者姓名:金馨  赵建新  姚艺  黄俊杰  张峰  李兴彪  叶光华  范琰琰  黄定品  夏能志  邹冬华  刘宁国  喻林升
作者单位:温州医科大学法医学系;温州医科大学司法鉴定中心;嘉兴学院医学院病理与法医学教研室;温州医科大学附属第一医院;司法鉴定科学研究院
基金项目:“十三五”国家重点研发计划资助项目(2016YFC0800702);上海市法医学重点实验室资助项目(17DZ2273200);上海市司法鉴定专业技术服务平台资助项目(19DZ2292700)。
摘    要:目的探讨CT扫描技术在医疗纠纷死亡原因鉴定中的应用价值。方法在2017年7月至2018年12月间,对12例医疗纠纷案例行全身CT检验,比较CT影像诊断与解剖所见及生前与死后CT诊断的差异性,分析尸体的CT常规检验在病变与损伤的诊断方面的优势与劣势。结果 CT影像诊断与解剖所见比较显示,在密度改变差异大的病变和损伤的诊断方面CT检验存在优势,如肺不张、肺炎、钙化、骨折、出血等;生前与死后CT诊断的比较显示医疗纠纷案件的尸体保存都较为良好,死后CT扫描检验对生前疾病诊断具有意义。结论虚拟解剖技术在医疗纠纷尸体检验中有较高的应用价值,可在尸体解剖前为鉴定人提供有效信息,也可在无法进行解剖的情况下为死亡原因分析提供参考依据。

关 键 词:法医病理学  虚拟解剖  体层摄影术,螺旋计算机  尸体解剖  死亡原因  医疗纠纷

Application of Virtual Anatomy Technology in Postmortem Examination of Medical Dispute Cases
JIN Xin,ZHAO Jian-xin,YAO Yi,HUANG Jun-jie,ZHANG Feng,LI Xing-biao,YE Guang-hua,FAN Yan-yan,HUANG Ding-pin,XIA Neng-zhi,ZOU Dong-hua,LIU Ning-guo,YU Lin-sheng. Application of Virtual Anatomy Technology in Postmortem Examination of Medical Dispute Cases[J]. Journal of Forensic Medicine, 2020, 0(1): 72-76
Authors:JIN Xin  ZHAO Jian-xin  YAO Yi  HUANG Jun-jie  ZHANG Feng  LI Xing-biao  YE Guang-hua  FAN Yan-yan  HUANG Ding-pin  XIA Neng-zhi  ZOU Dong-hua  LIU Ning-guo  YU Lin-sheng
Affiliation:(Department of Forensic Medicine,Wenzhou Medical University,Wenzhou 325035,Zhejiang Province,China;Judicial Forensic Center,Wenzhou Medical University,Wenzhou 325035,Zhejiang Province,China;Department of Pathology and Forensic Medicine,Jiaxing University Medical College,Jiaxing 314001,Zhejiang Province,China;The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,Zhejiang Province,China;Shanghai Key Laboratory of Forensic Medicine,Key Laboratory of Forensic Science,Ministry of Justice,Shanghai Forensic Service Platform,Academy of Forensic Science,Shanghai 200063,China)
Abstract:Objective To discuss the application value of CT scanning technology in cause of death determination of medical dispute cases. Methods From July 2017 to December 2018, postmortem CT imaging data of 12 medical dispute cases were collected. CT imaging diagnosis results and anatomy findings as well as differences between antemortem and postmortem CT diagnosis were compared. The advantages and disadvantages of CT routine tests of the cadavers in terms of the diagnosis of disease and damage were analyzed. Results The comparison between CT imaging diagnosis and anatomical findings showed that CT scans had advantages in the diagnosis of disease and damage with large differences in density changes, such as atelectasis, pneumonia, calcification, fracture and hemorrhage, etc. The comparison of CT diagnosis in antemortem and postmortem examination showed that the cadavers of medical dispute cases were well preserved and that postmortem CT scan was meaningful for the diagnosis of antemortem diseases. Conclusion Virtual anatomy technology has a relatively high application value in postmortem examination of medical dispute cases. It can provide effective information for the appraisers before the autopsy and can also provide a reference for cause of death analysis when the anatomy cannot be performed.
Keywords:forensic pathology  virtual anatomy  tomography,spiral computed  autopsy  cause of death  medical dispute
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