Emergency and Trauma Imaging Division, Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Cardiothoracic Imaging Division, Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Can Assoc Radiol J. 2020 Aug;71(3):403-414. doi: 10.1177/0846537120909503. Epub 2020 Mar 16.
As forensic radiology sees an exponential gain in popularity, postmortem computed tomography (PMCT) is increasingly being used in the appropriate setting, either as preautopsy guidance or as part of complementary virtual autopsy protocol. Many articles have expounded the value it adds to forensic pathology in the general setting and the appropriate technical parameters to be used for optimum benefit. We aim to put forth a concise review on the role of PMCT specifically in trauma and the pitfalls to be aware of. Reviews have shown that presumed cause of death in trauma have been proven by autopsy to be wrong in about 30% cases. Radiology applied to postmortem investigation in unnatural deaths and more specifically in trauma shares many semiotic features with emergency radiology. Therefore, in the near future, emergency radiologists might be required to integrate this type of imaging in their regular practice. Although the predominant drawbacks are time-dependent, PMCT also has some difficulty in differentiating antemortem and postmortem events. However, in many such scenarios, PMCT and autopsy play a complementary role in arriving at conclusions, and we believe understanding the benefits and role in trauma is imperative considering the expanding usage of PMCT.
随着法医放射学的普及呈指数级增长,死后计算机断层扫描(PMCT)越来越多地在适当的情况下使用,无论是作为尸检前的指导,还是作为补充虚拟尸检协议的一部分。许多文章都阐述了它在一般情况下为法医病理学增加的价值,以及为获得最佳效果而使用的适当技术参数。我们旨在对 PMCT 在创伤中的具体作用以及需要注意的陷阱进行简明扼要的综述。综述表明,在大约 30%的情况下,尸检证明创伤中的死因被认为是错误的。应用于非自然死亡的法医学尸检调查,更具体地说是应用于创伤的放射学与急诊放射学有许多相同的特征。因此,在不久的将来,急诊放射科医生可能需要将这种类型的影像学纳入他们的常规实践。尽管主要的缺点是时间依赖性的,但 PMCT 也很难区分生前和死后的事件。然而,在许多这种情况下,PMCT 和尸检在得出结论方面发挥着互补作用,我们认为,考虑到 PMCT 的广泛应用,了解其在创伤中的益处和作用至关重要。