Soon Lai Poh, Subramaniam Kunasilan, Madon Nor Fadhilah, Mohamad Noor Mohamad Helmee, Chainchel Singh Mansharan Kaur, Mahmood Mohd Shah
Department of Forensic Medicine, National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForm), Universiti Teknologi MARA (UiTM), Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh, Selangor, Malaysia, Aras 4, Bangunan Akademik, Kampus Sungai Buloh, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia.
Indian J Radiol Imaging. 2019 Jul-Sep;29(3):305-309. doi: 10.4103/ijri.IJRI_2_19. Epub 2019 Oct 30.
The aim of this study is to correlate urinary bladder distension and pulmonary edema on postmortem computed tomography (CT) scans with toxicology results in postmortem cases.
The study population was the postmortem cases of Asian population ranging from 16 to 75 years old in which blood and/or urine samples sent for alcohol and/or drug of abuse (DoA) analysis in year 2016 at our centre. Out of 434 cases, 54 from each group of positive and negative alcohol and/or DoA. Postmortem findings of lungs and postmortem CT scan urinary bladder volume (UBV) were recorded. Statistical significant correlation was obtained between urinary bladder distension on postmortem CT scan and cases with positive alcohol detection. However, the sensitivity was relatively low at 51.7%, whereas the specificity was 75% at the cut-off point. Low sensitivity and specificity at around 52.7% were obtained for pulmonary edema related to alcohol/DoA. This showed that UBV alone or pulmonary edema alone was not really a good indicator for alcohol or DoA intoxication. However, combination of both indicators provided higher sensitivity (73.3%) although specificity was lowered to 53.8%.
The findings of postmortem CT scan bladder distension and pulmonary edema could possibly identify intoxication cases but not conclusive.
本研究旨在将尸检计算机断层扫描（CT）上的膀胱扩张和肺水肿与尸检案例中的毒理学结果相关联。
研究人群为2016年在我们中心进行血液和/或尿液样本酒精和/或药物滥用（DoA）分析的16至75岁亚洲人群的尸检案例。在434例案例中，酒精和/或DoA阳性和阴性组各有54例。记录肺部的尸检结果和尸检CT扫描膀胱容积（UBV）。在尸检CT扫描上的膀胱扩张与酒精检测呈阳性的案例之间获得了统计学上的显著相关性。然而，敏感性相对较低，为51.7%，而在临界点时特异性为75%。与酒精/DoA相关的肺水肿的敏感性和特异性在52.7%左右较低。这表明单独的UBV或单独的肺水肿并不是酒精或DoA中毒的良好指标。然而，则两个指标的组合提供了更高的敏感性（73.3%），尽管特异性降至53.8%。
尸检CT扫描膀胱扩张和肺水肿的结果可能识别中毒案例，但并非结论性的。
