Dirnhofer Richard, Jackowski Christian, Vock Peter, Potter Kimberlee, Thali Michael J
Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland.
Radiographics. 2006 Sep-Oct;26(5):1305-33. doi: 10.1148/rg.265065001.
Invasive "body-opening" autopsy represents the traditional means of postmortem investigation in humans. However, modern cross-sectional imaging techniques can supplement and may even partially replace traditional autopsy. Computed tomography (CT) is the imaging modality of choice for two- and three-dimensional documentation and analysis of autopsy findings including fracture systems, pathologic gas collections (eg, air embolism, subcutaneous emphysema after trauma, hyperbaric trauma, decomposition effects), and gross tissue injury. Various postprocessing techniques can provide strong forensic evidence for use in legal proceedings. Magnetic resonance (MR) imaging has had a greater impact in demonstrating soft-tissue injury, organ trauma, and nontraumatic conditions. However, the differences in morphologic features and signal intensity characteristics seen at antemortem versus postmortem MR imaging have not yet been studied systematically. The documentation and analysis of postmortem findings with CT and MR imaging and postprocessing techniques ("virtopsy") is investigator independent, objective, and noninvasive and will lead to qualitative improvements in forensic pathologic investigation. Future applications of this approach include the assessment of morbidity and mortality in the general population and, perhaps, routine screening of bodies prior to burial.
侵入性“开体”尸检是人类传统的尸检调查方式。然而,现代横断面成像技术可以作为补充,甚至可能部分取代传统尸检。计算机断层扫描(CT)是用于二维和三维记录及分析尸检结果的成像方式,这些结果包括骨折系统、病理性气体聚集(如空气栓塞、创伤后皮下气肿、高压创伤、尸体腐败效应)以及大体组织损伤。各种后处理技术可为法律程序提供有力的法医证据。磁共振(MR)成像在显示软组织损伤、器官创伤和非创伤性病症方面产生了更大影响。然而,生前与死后MR成像所见形态学特征和信号强度特征的差异尚未得到系统研究。利用CT和MR成像及后处理技术(“虚拟尸检”)对尸检结果进行记录和分析独立于调查人员、客观且无创,将导致法医病理学调查在质量上得到改进。这种方法未来的应用包括评估普通人群的发病率和死亡率,或许还包括在埋葬前对尸体进行常规筛查。