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一例触电致死案件及独特的法医放射学尸检结果

A fatal case of electrocution with unique forensic radiological postmortem findings.

作者信息

Baumeister Rilana, Mauf Sabrina, Laberke Patrick, Krupp Anais, Thali Michael J, Flach Patricia M

机构信息

Institute of Forensic Medicine, Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.

出版信息

Forensic Sci Med Pathol. 2015 Dec;11(4):589-95. doi: 10.1007/s12024-015-9716-2. Epub 2015 Oct 5.

DOI:10.1007/s12024-015-9716-2
PMID:26434653
Abstract

PURPOSE

Documentation of forensic radiological observations in postmortem imaging of electrical injuries is not common yet and is less prevalent compared to other forms of burn injuries. However, electrical injuries have high morbidity and mortality. The objective of this case report was the visualization and evaluation of unique electrocution-related injuries by postmortem contrast and non-contrast enhanced imaging compared to a forensic autopsy.

METHODS

Forensic imaging included whole-body postmortem computed tomography (PMCT), PMCT-angiography (PMCTA), postmortem magnetic resonance tomography (PMMR), and PMMR-angiography (PMMRA). Initial external inspection and subsequent autopsy were performed.

RESULTS

Imaging results revealed intestinal mucosal pathologies, particularly of the gastric vascular integrity and remarkable rhabdomyolysis of the striated muscles of the extremities. Furthermore, PMCT and PMCTA revealed a hepatic lesion with perihepatic free fluid. The results from external inspection and autopsy correlated to the well-known pathologies of electrocution in the course of a high-voltage incident.

CONCLUSION

Postmortem imaging visualized electrocution-related injuries and aided substantially in the medico-legal investigation. These findings, particularly of the rhabdomyolysis in magnetic resonance tomography, may support the future image interpretation of cases with electrical injuries-in the living and the deceased.

摘要

目的

在电损伤尸体成像中记录法医放射学观察结果的情况尚不常见,与其他形式的烧伤相比也不太普遍。然而,电损伤具有较高的发病率和死亡率。本病例报告的目的是通过尸体对比增强和非对比增强成像与法医尸检相比,可视化并评估与触电相关的独特损伤。

方法

法医成像包括全身尸体计算机断层扫描(PMCT)、PMCT血管造影(PMCTA)、尸体磁共振断层扫描(PMMR)和PMMR血管造影(PMMRA)。进行了初步的外部检查和随后的尸检。

结果

成像结果显示肠道黏膜病变,特别是胃血管完整性以及四肢横纹肌明显的横纹肌溶解。此外,PMCT和PMCTA显示肝脏有病变且肝周有游离液体。外部检查和尸检结果与高压事件过程中触电的已知病理情况相关。

结论

尸体成像可视化了与触电相关的损伤,并在法医学调查中提供了很大帮助。这些发现,特别是磁共振断层扫描中的横纹肌溶解,可能有助于未来对电损伤病例(包括生前和死后)的图像解读。

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本文引用的文献

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Trauma Mon. 2014 Nov;19(4):e18748. doi: 10.5812/traumamon.18748. Epub 2014 Nov 25.
2
Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols.法医放射影像学:死后计算机断层扫描技术与方案图解指南
Forensic Sci Med Pathol. 2014 Dec;10(4):583-606. doi: 10.1007/s12024-014-9555-6. Epub 2014 Apr 11.
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Cardiac pathology in fatal electrocution.致命电击伤中的心脏病理学
Burns. 2014 Nov;40(7):e45-6. doi: 10.1016/j.burns.2014.02.001. Epub 2014 Mar 6.
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Rib fractures at postmortem computed tomography (PMCT) validated against the autopsy.死后计算机断层扫描(PMCT)肋骨骨折与尸检对照验证。
Forensic Sci Int. 2013 Dec 10;233(1-3):90-8. doi: 10.1016/j.forsciint.2013.08.025. Epub 2013 Sep 5.
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Heat haematoma: post-mortem computed tomography findings.热血肿:尸检计算机断层扫描结果
Clin Radiol. 2013 Feb;68(2):e95-7. doi: 10.1016/j.crad.2012.10.019. Epub 2012 Dec 7.
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Differentiation of ante-mortem and post-mortem fractures with MRI: a case report.MRI 鉴别生前和死后骨折:病例报告。
Br J Radiol. 2011 Apr;84(1000):e75-8. doi: 10.1259/bjr/10214495.
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Infiltrating carcinoma of the breast mimicking electrocution.酷似触电伤的乳腺浸润性癌
Forensic Sci Med Pathol. 2010 Mar;6(1):71-2. doi: 10.1007/s12024-009-9110-z. Epub 2009 Oct 17.
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Electrical injury of the neck and cardiac air embolism: a novel mechanism of death.
Forensic Sci Med Pathol. 2009;5(1):32-5. doi: 10.1007/s12024-008-9060-x. Epub 2008 Sep 20.
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Postmortem whole-body CT angiography: evaluation of two contrast media solutions.尸检全身CT血管造影:两种造影剂溶液的评估
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Eur J Radiol. 2008 Feb;65(2):311-5. doi: 10.1016/j.ejrad.2007.03.033. Epub 2007 May 4.