Charlier Philippe, Chaillot Pierre-Fleury, Watier Laurence, Ménétrier Mélissa, Carlier Robert, Cavard Stéphanie, Hervé Christian, de la Grandmaison Geoffroy Lorin, Huynh-Charlier Isabelle
Department of Forensic Medicine and Pathology, University Hospital R. Poincaré (AP-HP, UVSQ), France.
Med Sci Law. 2013 Oct;53(4):227-34. doi: 10.1177/0025802413479946. Epub 2013 Aug 14.
To investigate the interest of post-mortem ultrasonography in the diagnosis of pathological background, and manner and cause of death.
Post-mortem ultrasonography exams were carried out on 38 fresh human adult cadavers referred to the Department of Forensic Medicine and Pathology (Garches, France). Data obtained from ultrasonography were independently compared with further forensic autopsy findings.
Two important limitations relative to ultrasound utilization appeared: hyper-echoic abdominal and thoracic walls, with gas distension of the whole digestive tube and subcutaneous tissues (due to precocious putrefactive gas releasing); and difficulty in accessing lateral and posterior structures (i.e. liver, spleen, kidneys, lung bases, aorta) due to rigor mortis and evident non-compliance of the subject. Post-mortem diagnoses (moderate ascites, gallbladder stones, bladder globe, chronic kidney disease, cirrhosis, thyroid gland cysts and hypertrophy, intrauterine device), were strongly limited. False negative diagnoses comprised fatty liver, pleural effusion, thoracic aortic dissection, and focal organ and/or soft tissues lesions (for example, wounds or infarcts).
According to the results, post-mortem ultrasonography seems to have a very limited role for forensic purposes. Other post-mortem utilizations are cited, proposed, and discussed.
探讨尸检超声检查在病理背景诊断以及死亡方式和原因方面的应用价值。
对38具送至法国加尔什法医学与病理学系的新鲜成年人体尸体进行尸检超声检查。将超声检查获得的数据与进一步的法医尸检结果进行独立比较。
出现了与超声使用相关的两个重要局限性：腹部和胸壁回声增强，整个消化道和皮下组织存在气体扩张（由于早期腐败气体释放）；由于尸僵和尸体明显不配合，难以检查外侧和后侧结构（即肝脏、脾脏、肾脏、肺底部、主动脉）。尸检诊断（中度腹水、胆结石、膀胱充盈、慢性肾病、肝硬化、甲状腺囊肿和肥大、宫内节育器）受到很大限制。假阴性诊断包括脂肪肝、胸腔积液、胸主动脉夹层以及局灶性器官和/或软组织病变（例如伤口或梗死）。
根据结果，尸检超声检查在法医领域的作用似乎非常有限。文中还列举、提出并讨论了其他尸检应用。
