Juźwik Ewa, Moskała Artur, Woźniak Krzysztof, Kopacz Paweł
Katedra i Zakład Medycyny Sądowej, Collegium Medicum Uniwersytetu Jagiellońskiego, Kraków, Polska/Chair and Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland.
Arch Med Sadowej Kryminol. 2019;69(1-2):40-55. doi: 10.5114/amsik.2019.89235.
Post-mortem computed tomography (PMCT) is an examination technique which provides particular benefits in forensic medical practice in the evaluation of traumatic injuries. However, the usefulness of PMCT in the diagnosis of parenchymal structures in the human body is not obvious.
To evaluate the usefulness of PMCT in the diagnosis of parenchymal organ injuries (liver, pancreas, spleen and kidneys) and the presence of blood in the abdominal cavity.
The study was conducted on a population of deceased persons who underwent medicolegal autopsy in the Chair and Department of Forensic Medicine, Jagiellonian University Medical College in Krakow. The study included cases of violent death with the presence of blunt-force trauma. In all cases studied, the autopsy examination was preceded by PMCT. Both methods were employed to identify signs of injury to parenchymal organs and the presence of blood in the abdominal cavity. Observations made during the autopsies were considered in this study as the gold standard to which the PMCT findings were compared.
The data obtained in the study was analyzed statistically to determine a range of parameters including sensitivity, specificity, positive and negative predictive values, and reliability. The values were presented in a tabulated form.
The evaluation of usefulness of PMCT in the detection of abdominal parenchymal organ injuries and the presence of blood in the abdominal cavity failed to yield satisfactory results that would justify the application of PMCT in medicolegal practice as a diagnostic tool comparable to autopsy. However, promising results were obtained with respect to the suitability of PMCT as a screening test to exclude the presence of such injuries.
尸检计算机断层扫描(PMCT)是一种检查技术,在法医实践中评估创伤性损伤时具有特殊优势。然而,PMCT在诊断人体实质结构方面的实用性并不明显。
评估PMCT在诊断实质器官损伤(肝脏、胰腺、脾脏和肾脏)以及腹腔内有无血液方面的实用性。
本研究以在克拉科夫雅盖隆大学医学院法医学系进行法医尸检的死者群体为对象。研究包括存在钝器伤的暴力死亡病例。在所有研究病例中,尸检前均先进行PMCT检查。两种方法均用于识别实质器官损伤的迹象以及腹腔内有无血液。本研究将尸检过程中的观察结果视为金标准,并将PMCT的检查结果与之进行比较。
对研究中获得的数据进行统计分析,以确定一系列参数,包括敏感性、特异性、阳性和阴性预测值以及可靠性。这些值以表格形式呈现。
评估PMCT在检测腹部实质器官损伤及腹腔内有无血液方面的实用性,未能得出令人满意的结果,不足以证明在法医实践中可将PMCT作为与尸检相当的诊断工具应用。然而,在PMCT作为排除此类损伤存在的筛查试验的适用性方面,取得了有前景的结果。