Jakobsen Lykke Schrøder, Lundemose Sissel, Banner Jytte, Lynnerup Niels, Jacobsen Christina
Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark.
Forensic Sci Med Pathol. 2016 Dec;12(4):510-516. doi: 10.1007/s12024-016-9810-0. Epub 2016 Sep 28.
The purpose of this study was to investigate the utility of postmortem computed tomography (PMCT) images in estimating organ sizes and to examine the use of the cardiothoracic ratio (CTR).
We included 45 individuals (19 females), who underwent a medico-legal autopsy. Using the computer software program Mimics, we determined in situ heart and liver volumes derived from linear measurements (width, height and depth) on a whole body PMCT-scan, and compared the volumes with ex vivo volumes derived by CT-scan of the eviscerated heart and liver. The ex vivo volumes were also compared with the organ weights. Further, we compared the CTR with the ex vivo heart volume and a heart weight-ratio (HWR). Intra- and inter-observer analyses were performed.
We found no correlation between the in situ and ex vivo volumes of the heart and liver. However, a highly significant correlation was found between the ex vivo volumes and weights of the heart and liver. No correlations between CTR and the ex vivo heart volume nor with HWR was found. Concerning cardiomegaly, we found no agreement between the CTR and HWR. The intra- and inter-observer analyses showed no significant differences.
Noninvasive in situ PMCT methods for organ measuring, as performed in this study, are not useful tools in forensic pathology. The best method to estimate organ volume is a CT-scan of the eviscerated organ. PMCT-determined CTR seems to be useless for ascertaining cardiomegaly, as it neither correlated with the ex vivo heart volume nor with the HWR.
本研究旨在探讨尸检计算机断层扫描（PMCT）图像在估计器官大小方面的实用性，并研究心胸比（CTR）的应用。
我们纳入了45例接受法医尸检的个体（19名女性）。使用计算机软件程序Mimics，我们根据全身PMCT扫描的线性测量值（宽度、高度和深度）确定原位心脏和肝脏体积，并将这些体积与通过对取出的心脏和肝脏进行CT扫描得出的离体体积进行比较。还将离体体积与器官重量进行了比较。此外，我们将CTR与离体心脏体积和心脏重量比（HWR）进行了比较。进行了观察者内和观察者间分析。
我们发现心脏和肝脏的原位体积与离体体积之间无相关性。然而，发现心脏和肝脏的离体体积与重量之间存在高度显著的相关性。未发现CTR与离体心脏体积或HWR之间存在相关性。关于心脏肥大，我们发现CTR与HWR之间不一致。观察者内和观察者间分析均未显示出显著差异。
如本研究中所进行的用于器官测量的非侵入性原位PMCT方法，在法医病理学中并非有用的工具。估计器官体积的最佳方法是对取出的器官进行CT扫描。PMCT确定的CTR似乎对于确定心脏肥大无用，因为它既与离体心脏体积无关，也与HWR无关。
