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非可疑死亡调查中的尸检CT服务结构

Post-mortem CT service structures in non-suspicious death investigations.

作者信息

Davendralingam Natasha, Brookes Amy-Lee, Shah Mohammad Ali, Shelmerdine Susan C

机构信息

Department of Radiology, Tameside & Glossop NHS Foundation Trust, Ashton-under-Lynne, OL6 9RW, United Kingdom.

Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, United Kingdom.

出版信息

BJR Open. 2024 Oct 29;6(1):tzae036. doi: 10.1093/bjro/tzae036. eCollection 2024 Jan.

DOI:10.1093/bjro/tzae036
PMID:39552614
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568351/
Abstract

Post-mortem CT (PMCT) is increasingly used in adult post-mortem investigations as a non-invasive alternative to traditional autopsies. Using PMCT supports death investigations in the face of severe pathologist workforce shortages and the less invasive nature maintains respect for cultural sensitivities. This article reviews the diverse service structures of PMCT, highlighting the importance of customizing these structures to meet the specific needs of various coronial jurisdictions. These jurisdictions often face challenges such as limited access to imaging facilities and logistical issues with geographically dispersed mortuaries. We outline options for leading and operating PMCT services, including models led by pathologists, radiologist, or a hybrid of the two; use of static, relocatable, or mobile CT scanning units; as well as making the most of existing resources such as NHS or private scanning facility scanners already in place. We also explore different PMCT reporting structures through in-house NHS radiologists, combined in-house and teleradiology, or fully outsourced teleradiology services. Each of these offerings provides different levels of efficiency, cost-effectiveness, data security and challenges to set-up. Where applicable, we present and describe real-world examples as case studies for readers interested in replicating existing models.

摘要

尸检CT(PMCT)越来越多地用于成人尸检调查,作为传统尸检的一种非侵入性替代方法。在病理学家劳动力严重短缺的情况下,使用PMCT有助于死亡调查,而且其侵入性较小的特点也维护了对文化敏感性的尊重。本文回顾了PMCT的多种服务结构,强调了根据不同死因裁判辖区的具体需求定制这些结构的重要性。这些辖区常常面临诸如难以使用成像设备以及地理上分散的停尸房所带来的后勤问题等挑战。我们概述了引领和运营PMCT服务的选项,包括由病理学家、放射科医生或两者混合主导的模式;使用静态、可移动或移动CT扫描设备;以及充分利用现有资源,如已有的国民保健制度(NHS)或私人扫描设施的扫描仪。我们还探讨了通过NHS内部放射科医生、内部与远程放射学相结合或完全外包的远程放射学服务等不同的PMCT报告结构。这些服务各自在效率、成本效益、数据安全以及设立的挑战方面提供了不同的水平。在适用的情况下,我们展示并描述实际案例,作为对复制现有模式感兴趣的读者的案例研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/38cc42f09184/tzae036f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/8b67155ea631/tzae036f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/5657c85e5ff1/tzae036f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/38cc42f09184/tzae036f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/8b67155ea631/tzae036f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/5657c85e5ff1/tzae036f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c51/11568351/38cc42f09184/tzae036f3.jpg

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本文引用的文献

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Sci Rep. 2024 Mar 16;14(1):6393. doi: 10.1038/s41598-024-56089-z.
2
Impact of the COVID-19 pandemic on a post-mortem CT service for adult non-suspicious death.COVID-19 大流行对成人非疑似死亡死后 CT 服务的影响。
Clin Radiol. 2023 Nov;78(11):822-831. doi: 10.1016/j.crad.2023.03.013. Epub 2023 Aug 14.
3
Impact of changing from autopsy to post-mortem CT in an entire HM Coroner region due to a shortage of available pathologists.
尸体解剖检查的演变:关于尸检衰落及影像学在其复兴中作用的历史视角
Front Radiol. 2025 Apr 14;5:1565012. doi: 10.3389/fradi.2025.1565012. eCollection 2025.
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Teleradiology: good practice guide.远程放射学:实践指南。
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