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尸体计算机断层扫描:在枪伤死亡案例中是有用还是多余?两例病例报告。

Post mortem computed tomography: useful or unnecessary in gunshot wounds deaths? Two case reports.

作者信息

Maiese Aniello, Gitto Lorenzo, De Matteis Alessandra, Panebianco Valeria, Bolino Giorgio

机构信息

Department of Anatomy, Histology, Forensic Medicine and Orthopedics,''Sapienza" University of Rome, Rome, Italy.

Department of Anatomy, Histology, Forensic Medicine and Orthopedics,''Sapienza" University of Rome, Rome, Italy.

出版信息

Leg Med (Tokyo). 2014 Nov;16(6):357-63. doi: 10.1016/j.legalmed.2014.06.005. Epub 2014 Jun 19.

Abstract

Post-mortem computer tomography (PMCT) is currently an useful procedure that can elucidate patterns of injuries, providing strong medical evidence that is very useful during litigation and at trial. This technique is especially useful in gunshot wounds cases, allowing an easier location and retrieval of the bullet and/or its fragments inside the body. In such cases, the use of 3D rendering can be very useful in order to obtain essential information, such as: accurate depict of the wound track, discerning between entrance and exit wounds, show bone's fracture and its fragments course inside the body. The authors performed analysis on two cases of death by gunshot wounds, and a PMCT before the postmortem examination was made. The obtained CT scans were evaluated using the open-source software OsiriX on a Mac OS X computer, performing 3D rendering of the DICOM images. The crime scene reconstruction was performed using the software Poser Debut® on a Mac OS X computer. In both cases, PMCT showed multiple advantages: objectivity, reproducibility, ease visualization of the wound paths, easy localization of bullet and their fragments, allowing us to clarify the cause of death before the traditional autopsy. PMCT should became a standard in forensic practice as an aid to the tradition postmortem examination to obtain as much information as possible in order to clarify the cause and manner of death.

摘要

尸检计算机断层扫描(PMCT)目前是一种有用的程序,它可以阐明损伤模式,提供有力的医学证据,这在诉讼和审判期间非常有用。该技术在枪伤案件中特别有用,能更轻松地定位和找回体内的子弹及/或其碎片。在这类案件中,使用三维重建非常有用,以便获取重要信息,例如:准确描绘伤口轨迹、区分入口和出口伤口、显示骨骼骨折及其在体内的碎片走向。作者对两起枪伤致死案件进行了分析,并在尸检前进行了PMCT检查。在Mac OS X计算机上使用开源软件OsiriX对获得的CT扫描图像进行评估,对DICOM图像进行三维重建。在Mac OS X计算机上使用Poser Debut®软件进行犯罪现场重建。在这两起案件中,PMCT都显示出多个优点:客观性、可重复性、伤口路径易于可视化、子弹及其碎片易于定位,使我们能够在传统尸检前明确死因。PMCT应成为法医实践中的一项标准,作为传统尸检的辅助手段,以获取尽可能多的信息,从而明确死亡原因和方式。

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