Levy Angela D, Harcke Howard T, Getz John M, Mallak Craig T
Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Am J Forensic Med Pathol. 2009 Jun;30(2):137-41. doi: 10.1097/PAF.0b013e3181879cc9.
This study compared autopsy with postmortem multidetector computed tomography (MDCT) findings in charred remains. Seventeen consecutive male subjects (mean age, 29.4 years) who perished in a fire-related event resulting in charred remains underwent total body MDCT immediately prior to routine autopsy that included serum carboxyhemoglobin measurement. MDCT showed all thermal tissue changes (skin and subcutaneous fat loss, skeletal muscle retraction, pugilistic attitude, cortical fractures, bone and organ destruction, thermal epidural hematoma, and thermal amputation) and established all fracture patterns that were lethal, but autopsy added the fire as a contributory cause of death when there was carboxyhemoglobin elevation. MDCT had limited value in determination of lethal vascular and visceral injuries. MDCT is an effective complement to autopsy in the setting of charred remains and may serve to augment a limited autopsy. This may be particularly useful in mass casualty scenarios.
本研究比较了烧焦尸体的尸检结果与死后多排螺旋计算机断层扫描（MDCT）结果。17名连续的男性受试者（平均年龄29.4岁）在与火灾相关的事件中死亡，尸体烧焦，在进行包括血清碳氧血红蛋白测量的常规尸检之前立即接受了全身MDCT检查。MDCT显示了所有热损伤组织变化（皮肤和皮下脂肪缺失、骨骼肌收缩、拳击样姿态、皮质骨折、骨骼和器官破坏、热致硬膜外血肿以及热截肢），并确定了所有致命的骨折类型，但当碳氧血红蛋白升高时，尸检将火灾列为死亡的一个促成原因。MDCT在确定致命性血管和内脏损伤方面价值有限。在烧焦尸体的情况下，MDCT是尸检的有效补充，可用于扩大有限的尸检范围。这在大规模伤亡场景中可能特别有用。
