Division of Diagnostic Radiology, Akita University Hospital, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
Jpn J Radiol. 2019 Mar;37(3):220-229. doi: 10.1007/s11604-018-0802-8. Epub 2019 Jan 1.
To investigate the effectiveness of postmortem computed tomography in the diagnosis of drowning, focusing on the comparison of fresh water and salt water cases using three-dimensionally (3D) reconstructed data.
We examined features of drowning in 25 fresh water drowning cases (FWDCs; 13 men, 12 women; mean age 73.1 years; range 43-95 years), and compared these with 12 salt water drowning cases (SWDCs; 5 men, 7 women; mean age 66.0 years; range 55-77 years). Pulmonary opacities, volume and density (CT number) of accumulated fluid in the paranasal sinuses and central airways, volume of the stomach/stomach contents, and cardiac blood density were examined.
In SWDCs, pulmonary ground-glass opacities with wholly thickened interstitium was frequently identified (P = 0.0274). Whereas in FWDCs, a significantly larger volume and lower density of fluid in the paranasal sinuses (P = 0.0195 and P = 0.0104, respectively), lower density of fluid in the central airways (P = 0.0077), lower stomach content density (P = 0.0216), lower density in the left atrium (P = 0.0029), and a difference of density between the atria (P = 0.0247) were observed.
A lower density in the left atrium was observed in FWDCs compared to SWDCs. This finding may be helpful in differentiating between FWDCs and SWDCs.
探讨死后计算机断层扫描（CT）在溺死诊断中的有效性，重点比较淡水和盐水溺死病例，并使用三维（3D）重建数据进行比较。
我们检查了 25 例淡水溺死病例（FWDC；13 男，12 女；平均年龄 73.1 岁；范围 43-95 岁）和 12 例盐水溺死病例（SWDC；5 男，7 女；平均年龄 66.0 岁；范围 55-77 岁）的溺死特征。检查了鼻窦和中央气道积水中的肺不张、体积和密度（CT 值）、胃/胃内容物的体积以及心脏血液密度。
SWDC 中常发现全肺间质增厚的磨玻璃样混浊（P=0.0274）。而在 FWDC 中，鼻窦中液体的体积明显增大，密度明显降低（P=0.0195 和 P=0.0104），中央气道中液体的密度降低（P=0.0077），胃内容物密度降低（P=0.0216），左心房密度降低（P=0.0029），心房密度差异（P=0.0247）。
FWDC 中的左心房密度明显低于 SWDC。这一发现有助于区分 FWDC 和 SWDC。
