Fetisov V A, Kuprina T A, Sinitsyn V E, Dubrova S E, Filimonov B A
Federal state budgetary institution 'Russian Centre of Forensic Medical Expertise', Russian Ministry of Health, Moscow, Russia, 125284.
Therapeutic and Rehabilitative Centre of the Russian Ministry of Health, Moscow, Russia, 125367.
Sud Med Ekspert. 2016 Mar-Apr;59(2):47-54. doi: 10.17116/sudmed201659247-54.
We undertook the analysis of the foreign publications concerning the application of the modern radiodiagnostic methods (including MSCT- and MRI-visualization) with reference to the solution of the traditional problems facing forensic medical expertise, such as the estimation of prescription of death coming and time of infliction of injury in the dead bodies. Both advantages and disadvantages of postmortem visualization of the corpses of adult subjects are discussed taking into consideration the period of time that elapsed between the death and the onset of the study as well as the character of the injuries. It was shown that the examination of the corpses using the up-to-date methods of radiodiagnostics prior to autopsy makes it possible for morphologists, jointly with radiologists, to identify, to see in the new light, and to evaluate the number of charges in the dead body, such as the alteration of the blood cell sedimentation rate, the formation of postmortem hypostases in the internal organs, the hardening of the walls of aorta and major blood vessels, right heart dilatation, gradual smoothing of the borderline between grey and white matter of the brain. Virtual autopsy can be useful , even for the study of such long-term processes in the corpses as putrefaction, saponification, mummification, and peat tanning. Moreover, this technique may be instrumental in the elucidation of the specific features of topographic-anatomical relationships between individual 'tissues and organs, detection of the concealed lesions, and a variety of pathological changes. Postmortem visualization allows for the quantitative evaluation of the severity of these transformations and the preliminary estimation of prescription of death coming. Also, radiodiagnostic methods can be employed to reliably visualize and measure various hemorrhagic events (from the density of such ones as liquid and clotted blood) in the tissues surrounding the fractures, in body cavities, and internal organs as well as to establish the facts of inter-vital aspiration of blood, alimentary masses, liquid and solid foreign bodies penetrating into the upper sections of the respiratory and gastrointestinal tracts as the consequence f an injury. It is concluded that the postmortem visualization techniques employed to estimate prescription of death coming and time of infliction of injury as well as other complicated problems facing forensic medical expertize need the further scientifically based development.
我们针对现代放射诊断方法(包括多层螺旋CT和磁共振成像可视化)在法医学鉴定传统问题解决中的应用,对国外相关出版物进行了分析,这些传统问题如推断死亡时间和尸体损伤时间。考虑到死亡与研究开始之间经过的时间以及损伤特征,讨论了成人尸体死后可视化的优缺点。结果表明,在尸检前使用最新放射诊断方法检查尸体,形态学家与放射科医生能够共同识别、以新视角观察并评估尸体中的一系列变化,如血细胞沉降率改变、内脏死后坠积形成、主动脉和主要血管壁硬化、右心扩张、脑灰质和白质边界逐渐变平滑。虚拟尸检甚至对研究尸体中的长期过程如腐败、皂化、木乃伊化和泥炭鞣化都可能有用。此外,该技术有助于阐明个体组织和器官之间地形解剖关系的特定特征、检测隐匿性病变以及各种病理变化。死后可视化允许对这些变化的严重程度进行定量评估,并初步推断死亡时间。而且,放射诊断方法可用于可靠地可视化和测量骨折周围组织、体腔和内脏中的各种出血事件(从液体和凝血等密度),以及确定生前血液、食物团块、液体和固体异物因损伤而进入呼吸道和胃肠道上段的情况。得出的结论是,用于推断死亡时间和损伤时间以及法医学鉴定面临的其他复杂问题的死后可视化技术需要进一步基于科学的发展。