Jian Junqi, Wan Lei, Shao Yu, Zou Donghua, Huang Ping, Wang Zhuoqun, Liu Ningguo, Chen Yijiu
Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China.
Department of Forensic Medicine, Soochow University, Suzhou, China.
Forensic Sci Res. 2019 Feb 23;6(2):152-158. doi: 10.1080/20961790.2018.1557386. eCollection 2021.
It may be difficult to distinguish the cause of death in drowning cases without specific findings. The aim of this study was to explore the forensic value of thoracic postmortem computed tomography (PMCT) using routine images and three-dimensional (3D) image reconstructions. The imaging data of PMCT examinations of six drowning cadavers, aged 21-54 years, were analyzed. Twelve victims of sudden death from coronary artery disease (CAD) were chosen as a control group. After 3D bilateral lung images were reconstructed using image processing software, an interactive medical image control system was used to measure and analyze parameters including lung volume, lung volume ratio, mean CT value of the whole lung, and lung CT value distribution curves. Lung volume and lung volume ratio were used to assess the shape changes of the lung. Lung CT value distribution curves showed the corresponding number of pixels of the different CT values in the lung image. Lung volume was not significantly larger in drowning cases (mean 2 958 cm) than in controls (mean 2 342 cm). Lung volume ratio values in the drowning group (mean 0.3156) were greater than those in the control group (mean 0.2763); ( = 0.02). There was no significant difference between the drowning and control group in the mean CT value of the whole lung. There were differences between lung CT value distribution curves in drowning victims and controls, with drowning victims showing a single peak and CAD cases showing a bimodal distribution. Thoracic PMCT is helpful for the forensic medical diagnosis of drowning. Lung volume ratio and lung CT value distribution are potential indicators to distinguish between drowning and CAD.
在没有特定发现的情况下，溺水案件的死因可能难以区分。本研究的目的是探讨胸部尸体计算机断层扫描（PMCT）使用常规图像和三维（3D）图像重建的法医学价值。分析了6例年龄在21 - 54岁之间的溺水尸体的PMCT检查成像数据。选择12例冠状动脉疾病（CAD）猝死受害者作为对照组。使用图像处理软件重建3D双侧肺图像后，使用交互式医学图像控制系统测量和分析包括肺体积、肺体积比、全肺平均CT值和肺CT值分布曲线等参数。肺体积和肺体积比用于评估肺的形态变化。肺CT值分布曲线显示肺图像中不同CT值对应的像素数量。溺水病例的肺体积（平均2958cm）并不显著大于对照组（平均2342cm）。溺水组的肺体积比值（平均0.3156）大于对照组（平均0.2763）；（P = 0.02）。溺水组和对照组全肺平均CT值无显著差异。溺水受害者和对照组的肺CT值分布曲线存在差异，溺水受害者显示单峰分布，CAD病例显示双峰分布。胸部PMCT有助于溺水的法医学诊断。肺体积比和肺CT值分布是区分溺水和CAD的潜在指标。
