Hyodoh Hideki, Terashima Ryuji, Rokukawa Masumi, Shimizu Junya, Okazaki Shunichiro, Mizuo Keisuke, Watanabe Satoshi
Dept. Legal Medicine, Sapporo Medical University, School of Medicine, Japan.
Dept. Legal Medicine, Sapporo Medical University, School of Medicine, Japan.
Leg Med (Tokyo). 2016 Mar;19:11-5. doi: 10.1016/j.legalmed.2016.01.006. Epub 2016 Jan 14.
Experimental drowning models were prepared to investigate the time-related course of lung changes using postmortem CT. This study was approved by our institutional animal ethics committee.
Fifteen NZW rabbits (female fifteen, 2.6-4.3 (mean 3.3)kg) were divided into 3 groups: fresh water drowning (FRESH), sea water drowning (SEA), and sea water drowning with anterior chest compression (ACC). All individuals were examined by CT (Aquilion CX, Toshiba, Japan) on postmortem time course. The rabbit's head was submerged in a water bath for a total of 10 min. In ACC, cardiopulmonary resuscitation was performed for 2 min, additionally. The percentage of aerated lung volumes (%ALV=100 (aerated lung volume/total lung volume)) were statistically evaluated and the lung CT image patterns and pleural fluid appearance time were investigated.
All lungs had decreased their %ALV within 24h, and there were no statistical differences in and among the 3 groups. After 36 h, %ALV tended to increase in all groups, and only ACC presented a statistical difference between 1h and 36 h (p<0.005). On postmortem lung CT, all lungs presented ground-glass opacity with interstitial thickening spread pattern (100%) and no pattern change during the follow-up period. After presenting pleural space fluid collection, the %ALV tended to increase.
There were no differences among FRESH, SEA, and ACC in %ALV within 24h. Only ground-glass opacity could be detected on postmortem lung CT, experimentally.
制备实验性溺水模型,利用死后CT研究肺变化的时间相关过程。本研究经我们机构的动物伦理委员会批准。
15只新西兰白兔(雌性15只,体重2.6 - 4.3(平均3.3)千克)分为3组:淡水溺水组(FRESH)、海水溺水组(SEA)和前胸按压海水溺水组(ACC)。在死后不同时间对所有个体进行CT检查(Aquilion CX,东芝,日本)。将兔头浸入水浴中总共10分钟。在ACC组中,额外进行2分钟的心肺复苏。对充气肺体积百分比(%ALV = 100×(充气肺体积/总肺体积))进行统计学评估,并研究肺CT图像模式和胸腔积液出现时间。
所有肺在24小时内%ALV均下降,3组之间及组内均无统计学差异。36小时后,所有组的%ALV均有上升趋势,只有ACC组在1小时和36小时之间存在统计学差异(p < 0.005)。死后肺CT显示,所有肺均呈现磨玻璃影伴间质增厚扩散模式(100%),随访期间无模式变化。出现胸腔积液后,%ALV有上升趋势。
FRESH、SEA和ACC组在24小时内的%ALV无差异。实验性死后肺CT仅能检测到磨玻璃影。