Garetier M, Deloire L, Dédouit F, Dumousset E, Saccardy C, Ben Salem D
Department of Radiology, Military Teaching Hospital Clermont-Tonnerre, Brest, France; Department of Radiology, Hôpital Morvan, University Hospital of Brest, Brest, France.
Department of Neuroradiology, Forensic Imaging Unit, Hôpital La Cavale Blanche, University Hospital of Brest, Brest, France.
Diagn Interv Imaging. 2017 Feb;98(2):101-112. doi: 10.1016/j.diii.2016.06.023. Epub 2016 Sep 26.
Suicide is the eighth cause of mortality in France and the leading cause in people aged between 25 and 34 years. The most common methods of suicide are hanging, self-poisoning with medicines and firearms. Postmortem computed tomography (CT) is a useful adjunct to autopsy to confirm suicide and exclude other causes of death. At autopsy, fractures of the hyoid bone or thyroid cartilage, or both, are found in more than 50% of suicidal hangings. Cervical vertebra fractures are rare and only seen in suicide victims jumping from a great height. Three-dimensional reconstructions from CT data are useful to visualize the ligature mark on the neck. In suicides by firearm, postmortem CT shows entry and exit wounds, parenchymal lesions along the bullet path, as well as projectiles in case of penetrating trauma. However, in the chest and abdomen it is more difficult to identify the path of the projectile. Postmortem CT also shows specific features of suicide by drowning or stabbing, but its use is limited in cases of self-poisoning. The use of postmortem CT is also limited by decomposition and change of body position. This article presents the imaging features seen on postmortem CT according to the method of suicide.
自杀是法国第八大致死原因，也是25至34岁人群的首要死因。最常见的自杀方式是上吊、服药自杀和使用枪支。尸检计算机断层扫描（CT）是尸检的有用辅助手段，可用于确认自杀并排除其他死因。尸检时，超过50%的上吊自杀者会发现舌骨或甲状软骨骨折，或两者皆有。颈椎骨折很少见，仅见于从高处跳下的自杀受害者。CT数据的三维重建有助于观察颈部的勒痕。在枪击自杀中，尸检CT可显示入口和出口伤口、沿子弹路径的实质损伤，以及穿透性创伤时的射弹。然而，在胸部和腹部，更难确定射弹的路径。尸检CT还可显示溺水或刺伤自杀的特定特征，但在服药自杀的情况下其应用有限。尸检CT的使用也受到尸体腐烂和体位变化的限制。本文介绍了根据自杀方式在尸检CT上看到的影像学特征。
