Ong Hooi-Nee, Chen I-Hung, Hsieh Yu-Hsuan, Hsu Cho-Hsien, Weng Te-I, Chang Chin-Chen
Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan, University College of Medicine, Taipei, Taiwan; Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Forensic Pathology, Institute of Forensic Medicine, Ministry of Justice, New Taipei City, Taiwan.
J Formos Med Assoc. 2023 Apr;122(4):351-354. doi: 10.1016/j.jfma.2022.09.015. Epub 2022 Oct 14.
In order to determine the performance of postmortem computed tomography (PMCT) in identifying traumatic-relevant macroscopic findings in medico-legal cases, this retrospective observational pilot study involving nine trauma casualties who had received PMCT prior to autopsy. The comparison of these findings in six anatomical regions as dictated in Injury Severity Score (ISS) were performed. 104 traumatic-relevant findings were identified with achievement of 51% congruent findings. PMCT and autopsy had additionally found 22 and 29 findings respectively. PMCT had highest sensitivity for extremity injury (81.82%), followed by chest (73.91%), head, neck and face (71.43%), and abdomino-pelvic area (50%). It had excellent detection rate in abnormal air collection, fracture, foreign body localization, internal ballistic and intracranial pathology. However, the solid organ and vascular injuries as well as integumentary lesions were the major drawback. In conclusion, incorporation of PMCT to autopsy in medico-legal investigation helps to preserve the most abundant traumatic-relevant injuries compared to either modality.
为了确定尸检计算机断层扫描（PMCT）在法医学案件中识别创伤相关宏观发现的性能，这项回顾性观察性试点研究纳入了9例在尸检前接受过PMCT检查的创伤伤亡者。按照损伤严重程度评分（ISS）的要求，对六个解剖区域的这些发现进行了比较。共识别出104个创伤相关发现，其中51%的发现一致。PMCT和尸检还分别发现了22个和29个发现。PMCT对四肢损伤的敏感性最高（81.82%），其次是胸部（73.91%）、头部、颈部和面部（71.43%）以及腹部盆腔区域（50%）。它在异常气体聚集、骨折、异物定位、体内弹道和颅内病变方面具有出色的检测率。然而，实体器官和血管损伤以及皮肤损伤是其主要缺点。总之，在法医学调查中，将PMCT与尸检相结合，相比于单独使用任何一种方式，有助于保留最多的创伤相关损伤。
