Institute of Forensic Medicine, Center of Forensic imaging and Virtopsy, University of Bern, Bühlstrasse 20, 3012 Bern, Switzerland.
Forensic Sci Int. 2013 May 10;228(1-3):e76-80. doi: 10.1016/j.forsciint.2013.01.039. Epub 2013 Feb 26.
A 65-year-old man collapsed suddenly, while on an escalator. Despite intensive cardio-pulmonary resuscitation, the subject died 1h later. Post-mortem magnetic resonance imaging and post-mortem computed tomography angiography demonstrated rupture of an ascending aortic aneurysm, with haemorrhage into the pericardial cavity and the uncommon associated finding of haemorrhage into the left hemi-thorax through a small left-sided pericardial defect. The cause of death was thus attributed to the rupture of thoracic aortic aneurysm, and traditional autopsy was not performed. The circumstances of the case will be discussed, followed by a discussion of the imaging findings, mechanism of death, and explanation of the findings in this case. Finally, on the basis of this case report, we suggest that in selected cases, post-mortem imaging can be used as a screening tool for conducting hypotheses on the cause and mechanism of death before autopsy.
一位 65 岁男性在乘坐自动扶梯时突然晕倒。尽管进行了心肺复苏术的强化治疗，该患者仍在 1 小时后死亡。尸检磁共振成像和尸检计算机断层血管造影显示升主动脉瘤破裂，血液进入心包腔，且罕见的伴随发现是通过一个较小的心包左侧缺损，血液进入左侧胸腔半侧。因此，死因归因于胸主动脉瘤破裂，并未进行传统的尸体解剖。本案例的情况将进行讨论，然后讨论影像学发现、死亡机制，并解释该案例中的发现。最后，根据本病例报告，我们建议在某些特定情况下，尸检成像可作为在尸检前对死因和死亡机制进行假设的筛查工具。
