Yamazaki Kentaro, Shiotani Seiji, Ohashi Noriyoshi, Doi Mikio, Honda Katsuya
Tsukuba Medical Examiner's Office, 3-1 Amakubo 1-chome, Tsukuba, Ibaraki 305-8558, Japan.
Leg Med (Tokyo). 2003 Mar;5 Suppl 1:S338-41. doi: 10.1016/s1344-6223(02)00166-9.
Postmortem computed tomography (PMCT) is useful for diagnosis of cause of death not only by emergency physicians but also medical examiners or police surgeons conducting postmortem studies. However, postmortem biological conditions are quite different from those in the living body. Hepatic portal venous gas (HPVG) and a hyperdense aortic wall (HDAW) are often found by PMCT, although no significant autopsy findings are evident in the liver or aorta. In this study we compared the findings of PMCT with those obtained at autopsy, and discussed the cause of these PMCT features. PMCT was conducted in 12 autopsy cases, comprising eight cases of natural death and four of unnatural death. HPVG was seen in five cases and HDAW in seven. In the cases showing HPVG, visceral abdominal injury, bowel distention or acute circulatory dysfunction was found at autopsy. In the cases showing HDAW, atherosclerosis or an increase in blood viscosity due to dehydration or postmortem changes was evident. Although the precise causes of these PMCT findings are not completely clear, the changes evident at autopsy provide some clues.
尸检计算机断层扫描（PMCT）不仅对急诊医生，而且对进行尸检研究的法医或法医外科医生诊断死因都很有用。然而，死后的生物学状况与活体中的状况有很大不同。尽管在肝脏或主动脉中没有明显的尸检结果，但通过PMCT经常可以发现肝门静脉气体（HPVG）和主动脉壁高密度（HDAW）。在本研究中，我们将PMCT的结果与尸检结果进行了比较，并讨论了这些PMCT特征的原因。对12例尸检病例进行了PMCT检查，其中包括8例自然死亡病例和4例非自然死亡病例。5例可见HPVG，7例可见HDAW。在显示HPVG的病例中，尸检发现腹部内脏损伤、肠扩张或急性循环功能障碍。在显示HDAW的病例中，明显存在动脉粥样硬化或因脱水或死后变化导致的血液粘度增加。虽然这些PMCT结果的确切原因尚不完全清楚，但尸检中明显的变化提供了一些线索。
