Laberke Patrick J, Fornaro Juergen, Kim Suk-kyum, Blum Simon, Augsburger Marc, Alkadhi Hatem, Wildermuth Simon, Hausmann Roland, Leschka Sebastian
Institute of Legal Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland,
Forensic Sci Med Pathol. 2015 Mar;11(1):20-8. doi: 10.1007/s12024-014-9643-7. Epub 2015 Jan 8.
To investigate the dual-energy CT behavior of cocaine and heroin and of typical adulterants, and to evaluate the elemental composition of pure cocaine and heroin compared with cocaine and heroin in bodypacks.
Pure heroin and pure synthetic cocaine samples, eight different adulterants, and in each case ten different bodypacks containing cocaine or heroin, were imaged at 80, 100, 120, and 140 kVp in a dual source CT system at two different degrees of compression. Two radiologists, blinded to the samples, measured the attenuation. The dual-energy index (DEI) was calculated. We performed atomic mass spectrometry for the elemental analysis of pure cocaine, pure heroin, and heroin and cocaine in bodypacks, and 140 kVp in a dual-source CT system.
Inter- and intra-observer agreement for attenuation measurements was good (r = 0.61-0.72; p < 0.01). The cocaine bodypacks had a positive DEI of 0.029, while the pure drugs and the heroin bodypacks had a negative DEI (-0.051 to -0.027). Levamisole was the only substance which expressed a positive DEI of 0.011, while the remaining adulterants had negative DEIs ranging between -0.015 and -0.215. Atomic mass spectrometry revealed a concentration of tin in the cocaine bodypack that was 67 times higher than in the pure synthetic cocaine sample.
The different DEIs of bodypacks containing cocaine and heroin allow them to be distinguished with dual-energy CT. Although the material properties of pure cocaine, pure heroin, or common drug extenders do not explain the differences in DEI, tin contamination during illicit natural cocaine production may be a possible explanation.
研究可卡因、海洛因及典型掺杂物在双能CT下的表现，并评估纯可卡因和海洛因与人体包裹物中可卡因和海洛因的元素组成。
在双源CT系统中，对纯海洛因和纯合成可卡因样本、八种不同的掺杂物以及每种情况下十个分别含有可卡因或海洛因的不同人体包裹物，在80、100、120和140 kVp的电压下，于两种不同压缩程度下进行成像。两名对样本不知情的放射科医生测量衰减情况，并计算双能指数（DEI）。我们对纯可卡因、纯海洛因、人体包裹物中的海洛因和可卡因进行了原子质量光谱分析，并在双源CT系统中采用140 kVp进行检测。
观察者间和观察者内对衰减测量的一致性良好（r = 0.61 - 0.72；p < 0.01）。含有可卡因的人体包裹物的DEI为正值0.029，而纯药物和含有海洛因的人体包裹物的DEI为负值（-0.051至-0.027）。左旋咪唑是唯一表现出正值DEI（0.011）的物质，而其余掺杂物的DEI为负值，范围在-0.015至-0.215之间。原子质量光谱分析显示，人体包裹物中可卡因的锡浓度比纯合成可卡因样本高67倍。
含有可卡因和海洛因的人体包裹物具有不同的DEI，可通过双能CT进行区分。尽管纯可卡因、纯海洛因或常见药物填充剂的物质特性无法解释DEI的差异，但非法天然可卡因生产过程中的锡污染可能是一个合理的解释。
