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腐败大脑宏观法医检查的冷冻准备

Freezing preparation for macroscopic forensic investigation in putrefied brain.

作者信息

Matoba Kotaro, Hyodoh Hideki, Murakami Manabu, Matoba Tomoko, Saito Atsuko, Feng Fei, Jin Shigeki

机构信息

Dep. Forensic Medicine, Graduate School of Medicine, Hokkaido University, Japan; Center for Cause of Death Investigation, Graduate School of Medicine, Hokkaido University, Japan.

Center for Cause of Death Investigation, Graduate School of Medicine, Hokkaido University, Japan.

出版信息

Leg Med (Tokyo). 2017 May;26:6-10. doi: 10.1016/j.legalmed.2017.01.005. Epub 2017 Jan 17.

DOI:10.1016/j.legalmed.2017.01.005
PMID:28549549
Abstract

PURPOSE

To evaluate the usefulness of the applied freezing technique in putrefied brain for macroscopic investigation.

MATERIALS AND METHODS

From October 2015 to September 2016, first the brains of 10 cadavers (control group: male 6, female 4, age 20-80 (mean 61.5), postmortem intervals (PMI) 14-75 (mean 29.7)days) were inspected following the standard practice (without freezing preparation), and then with 10 cadavers (freezing group: male 7, female 3, age 41-88 (mean 60.4), PMI 7-75 (mean 29.2)days) the freezing technique was used before the autopsy. The cut brain was investigated, and the gray-white matter difference was evaluated macroscopically.

RESULTS

In the control group, the brain parenchyma leaked out like sludge in 5, and there was difficulty maintaining its structure in 7. The gray-white matter difference was well visible in 3, but hard to distinguish in 3, and the total scores ranged from 0 to 9 (mean 4.4) points. In the freezing group, the entire putrefied brain was extracted as a solid organ, the gray-white matter differences were well visible, and the total scores were 6.7-9 (8.3) points. The gray-white matter difference was preserved in the freezing group (p<0.05).

CONCLUSION

The freezing procedures to evaluate the putrefied brain have been successfully applied, and it could be statistically more useful in putrefied brain investigation than the ordinary procedure. Postmortem CT can be useful to evaluate not only the degree of brain putrefaction, but also the degree of brain parenchyma freezing.

摘要

目的

评估应用冷冻技术对腐败大脑进行宏观检查的实用性。

材料与方法

2015年10月至2016年9月,首先按照标准操作(不进行冷冻处理)检查10具尸体的大脑(对照组:男性6例,女性4例,年龄20 - 80岁(平均61.5岁),死后间隔时间(PMI)14 - 75天(平均29.7天)),然后对另外10具尸体(冷冻组:男性7例,女性3例,年龄41 - 88岁(平均60.4岁),PMI 7 - 75天(平均29.2天))在尸检前使用冷冻技术。对切开的大脑进行检查,并宏观评估灰白质差异。

结果

对照组中,脑实质像泥浆一样流出的有5例,难以维持其结构的有7例。灰白质差异清晰可见的有3例,难以区分的有3例,总分在0至9分(平均4.4分)之间。冷冻组中,整个腐败大脑作为一个实体器官被取出,灰白质差异清晰可见,总分在6.7 - 9分(8.3分)之间。冷冻组的灰白质差异得以保留(p<0.05)。

结论

评估腐败大脑的冷冻程序已成功应用,且在腐败大脑检查中,从统计学角度看,它比普通程序更有用。尸检后CT不仅有助于评估脑腐败程度,还能评估脑实质冷冻程度。

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