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[临床影像学与法医影像学:差异、相似之处及法律框架]

[Between clinical and forensic imaging : Differences, similarities and legal framework].

作者信息

Bruch Gina Maria, Schäffer Benno, Sabel Bastian O

机构信息

Institut für Rechtsmedizin, LMU München, Nussbaumstr. 26, 80336, München, Deutschland.

Klinik und Poliklinik für Radiologie, LMU Kliniken, Marchioninistr. 15, 81337, München, Deutschland.

出版信息

Radiologie (Heidelb). 2024 Nov;64(11):830-836. doi: 10.1007/s00117-024-01361-6. Epub 2024 Aug 22.

DOI:10.1007/s00117-024-01361-6
PMID:39174666
Abstract

Clinical imaging uses a variety of medical imaging techniques to diagnose and monitor diseases, injuries and other health conditions. These include X‑ray images, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. These procedures are used to make accurate diagnoses and plan the best possible treatment for patients. Forensic imaging, in contrast, is used in both living and deceased persons in the context of criminal investigations. Postmortem forensic imaging techniques, such as postmortem CT (PMCT) and postmortem CT angiography (PMCTA), include some of the same procedures used in clinical imaging. An important difference between clinical and forensic imaging is the purpose and context in which the imaging studies are used. In addition, radiological procedures, such as angiography, need to be adapted and modified in the post-mortem setting. From a legal perspective clinical and forensic imaging must strictly adhere to privacy and procedural guidelines. Forensic images often need to be admissible as evidence in court, which places specific requirements on the quality, authenticity and documentation of images. In the case of living individuals, there must be a valid indication and consent from the patient. Consent must also fundamentally be obtained for post-mortem examinations, e.g. from the public prosecutor's office.

摘要

临床成像使用多种医学成像技术来诊断和监测疾病、损伤及其他健康状况。这些技术包括X光图像、计算机断层扫描(CT)、磁共振成像(MRI)和超声。这些检查用于做出准确诊断并为患者制定最佳治疗方案。相比之下,法医成像用于刑事调查中的活体和死者。尸检法医成像技术,如尸检CT(PMCT)和尸检CT血管造影(PMCTA),包括一些与临床成像相同的检查。临床成像和法医成像的一个重要区别在于成像研究的用途和背景。此外,血管造影等放射学检查在尸检环境中需要进行调整和修改。从法律角度来看,临床和法医成像必须严格遵守隐私和程序准则。法医图像通常需要作为法庭证据被采信,这对图像的质量、真实性和文件记录提出了特定要求。对于活体个体,必须有有效的指征并获得患者同意。对于尸检,也必须从根本上获得同意,例如来自检察官办公室的同意。

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本文引用的文献

1
Post mortem brain temperature and its influence on quantitative MRI of the brain.死后大脑温度及其对脑定量 MRI 的影响。
MAGMA. 2022 Jun;35(3):375-387. doi: 10.1007/s10334-021-00971-8. Epub 2021 Oct 29.
2
Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study.死后 CT 血管造影与尸检比较:一项法医学多中心研究。
Radiology. 2018 Jul;288(1):270-276. doi: 10.1148/radiol.2018170559. Epub 2018 May 1.
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Forensic Age Estimation.法医年龄推断。
Dtsch Arztebl Int. 2016 Jan 29;113(4):44-50. doi: 10.3238/arztebl.2016.0044.
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