Bolliger Stephan A, Ruder Thomas D, Ketterer Thomas, Gläser Nadine, Thali Michael J, Ampanozi Garyfalia
Institute of Forensic Medicine, Department of Forensic Medicine, Cantonal Hospital, Aarau, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Switzerland.
Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Bern, Switzerland; Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Switzerland; Institute of Diagnostic, Interventional, and Paediatric Radiology, University Hospital Bern, Switzerland.
Forensic Sci Int. 2014 Jan;234:45-9. doi: 10.1016/j.forsciint.2013.10.031. Epub 2013 Oct 31.
Instillation of contrast medium into stab wounds has shown promising results regarding visibility and assessment of general stab direction with computed tomography. However, the accuracy of this method--and, incidentally also probing of stab wounds--has to our knowledge not previously been examined. Also the effect of bluntness of different stabbing objects on the examination of stab wounds was not considered before this study.
Using a pocket-knife, a steak-knife, and a Phillips screwdriver, nine stab wounds each were inflicted to three pork haunches. The depths of the stab wounds were determined by probing and multislice computed tomography (MSCT) after instillation of a contrast medium (CM) and then compared to those observed by dissection, our internal "gold standard".
In stab wounds inflicted by knives, MSCT-CM and probing provided results which differed by roughly 10-11% from the dissection results. In screwdriver stabs MSCT-CM showed a deviation of almost 30%, probing over 33%.
MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate.
MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate.
在刺伤创口内注入造影剂，在利用计算机断层扫描观察创口可视性及总体刺伤方向评估方面已显示出有前景的结果。然而，据我们所知，此前尚未对该方法的准确性——顺便提一下，还有刺伤创口探查的准确性——进行过检验。在本研究之前，也未考虑不同刺伤工具的钝性对刺伤创口检查的影响。
使用一把袖珍小刀、一把牛排刀和一把十字螺丝刀，分别在三块猪后腿上各造成9处刺伤。在注入造影剂后，通过探查和多层计算机断层扫描（MSCT）确定刺伤创口的深度，然后与通过解剖观察到的深度（我们内部的“金标准”）进行比较。
在刀造成的刺伤创口中，MSCT造影剂成像和探查得出的结果与解剖结果相差约10% - 11%。在螺丝刀刺伤创口的情况中，MSCT造影剂成像显示偏差近30%，探查偏差超过33%。
在刀刺伤的尸检案例中，MSCT造影剂成像是逐层解剖的一种可能替代方法。探查虽然在死后检查中已过时，但在确定活人刺伤创口的长度方面足够准确。在诸如螺丝刀等钝器造成的刺伤创口案例中，MSCT造影剂成像和探查都未证明足够准确。
在刀刺伤的尸检案例中，MSCT造影剂成像是逐层解剖的一种可能替代方法。探查虽然在死后检查中已过时，但在确定活人刺伤创口的长度方面足够准确。在诸如螺丝刀等钝器造成的刺伤创口案例中，MSCT造影剂成像和探查都未证明足够准确。
