死后计算机断层扫描与尸检在创伤性颅脑损伤检测中的比较。
Comparison between postmortem computed tomography and autopsy in the detection of traumatic head injuries.
机构信息
Service d'imagerie morphologique et fonctionnelle, centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France; Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris, 102-108 rue de la Santé, 75014 Paris, France.
Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France; CNRS UMR 5288 Institut National de la transfusion sanguine, 6, rue Cabanel, 75015 Paris, France.
出版信息
J Neuroradiol. 2020 Feb;47(1):5-12. doi: 10.1016/j.neurad.2019.03.008. Epub 2019 Apr 4.
INTRODUCTION
The aim of this study was to assess the agreement between postmortem computed tomography (PMCT) and autopsy in detecting traumatic head injuries.
MATERIALS AND METHODS
Consecutive cases of death that underwent both unenhanced PMCT and conventional autopsy were collected from our institution database during a period of 3 years and reviewed retrospectively. PMCT images were reviewed for the presence of fractures (cranial vault, skull base, facial bones and atlas/axis) and intracranial hemorrhage. Kappa values were calculated to determine the agreement between PMCT and autopsy reports.
RESULTS
73 cases were included, of which 44 (60%) had head trauma. Agreement between PMCT and autopsy was almost perfect (κ = 0.95) for fractures and substantial (κ = 0.75) for intracranial hemorrhage. PMCT was superior to autopsy in detecting facial bone and upper cervical spine fractures, and intraventricular hemorrhage. However, in some cases thin extra-axial blood collections were missed on PMCT.
CONCLUSIONS
The agreement between PMCT and autopsy in detecting traumatic head injuries was good. Using a combination of both techniques increases the quality of postmortem evaluation because more lesions are detected.
简介
本研究旨在评估死后计算机断层扫描（PMCT）与尸检在检测外伤性头部损伤方面的一致性。
材料与方法
从我们机构的数据库中收集了 3 年来连续进行非增强 PMCT 和常规尸检的死亡案例，并进行回顾性分析。对 PMCT 图像进行检查，以确定是否存在骨折（颅盖、颅底、面骨和寰枢椎）和颅内出血。计算 Kappa 值以确定 PMCT 和尸检报告之间的一致性。
结果
共纳入 73 例，其中 44 例（60%）有头部外伤。PMCT 与尸检在检测骨折方面具有极好的一致性（κ=0.95），在检测颅内出血方面具有高度的一致性（κ=0.75）。PMCT 在检测面骨和上颈椎骨折以及脑室出血方面优于尸检。然而，在某些情况下，PMCT 可能会遗漏一些薄的硬脑膜外血液积聚。
结论
PMCT 与尸检在检测外伤性头部损伤方面的一致性良好。两种技术的结合使用可以提高死后评估的质量，因为可以检测到更多的病变。
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