Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy
Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy
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DOI：
10.1016/j.forsciint.2014.05.012
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发表时间：
2014-08-01
影响因子：
2.2
通讯作者：
Maeda, Hitoshi
中科院分区：
文献类型：
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作者：
Sogawa, Nozomi;Michiue, Tomomi;Maeda, Hitoshi
尸检 CT (PMCT) 可用于研究体腔和内脏中的空气/气体分布和含量。本研究利用对无腐败气体形成的法医尸检病例（死后 3 天内，n = 75）的三维 (3-D) PMCT 数据分析，研究了估计肺总空气/气体含量和通气比作为终末呼吸功能可能指标的程序，并分析了有关死因的体积数据。当使用图像分析仪重建 3-D 双侧肺部图像时，溺水 (n = 12) 的合并肺容量大于酒精/镇静催眠中毒 (n = 8) 和心源性猝死 (SCD；n = 10)，而其他情况下的合并肺容量则为中间值，包括机械性窒息 (n = 12)、烧伤导致的火灾死亡 (n = 6) 和一氧化碳中毒 (n =) 7)、致命的甲基苯丙胺滥用 (n = 7)、体温过高（中暑；n = 6）和致命的体温过低（寒冷暴露；n = 7）。使用 -2000 至 -400（“有效”肺通气面积）和 -2000 至 -191（总肺通气面积）之间的 HU 间隔检测到的肺空气/气体含量以及与总肺容量的比率（分别为“有效”和总肺通气比率）在机械性窒息、溺水、致命烧伤和体温过低（冷暴露）中均高于 SCD，并且处于中等水平 在其他情况下。 “有效”和总肺通气量比率可能有助于比较特定死因，以区分体温过低（寒冷暴露）和药物中毒，以及 SCD 和其他死因。这些发现为 PMCT 数据分析肺容量和 CT 密度以及肺空气/气体含量和通气比与死因的潜在功效提供了有趣的见解，作为终末呼吸功能的可能指标，作为内脏原位虚拟尸检的一部分。 (C) 2014 Elsevier Ireland Ltd. 保留所有权利。
Postmortem CT (PMCT) is useful to investigate air/gas distribution and content in body cavities and viscera. The present study investigated the procedure to estimate total lung air/gas content and aeration ratio as possible indices of terminal respiratory function, using three-dimensional (3-D) PMCT data analysis of forensic autopsy cases without putrefactive gas formation (within 3 days postmortem, n = 75), and analyzed the volumetric data with regard to the cause of death. When 3-D bilateral lung images were reconstructed using an image analyzer, combined lung volume was larger in drowning (n = 12) than in alcohol/sedative-hypnotic intoxication (n = 8) and sudden cardiac death (SCD; n = 10), and intermediate in other cases, including mechanical asphyxiation (n = 12), fire fatalities due to burns (n = 6) and carbon monoxide intoxication (n = 7), fatal methamphetamine abuse (n = 7), hyperthermia (heatstroke; n = 6) and fatal hypothermia (cold exposure; n = 7). Air/gas content of the lung as detected using HU interval between -2000 and -400 ('effective' lung aeration areas) and between -2000 and -191 (total lung aeration areas) as well as the ratios to total lung volume ('effective' and total lung aeration ratios, respectively) was higher in mechanical asphyxiation, drowning, fatal burns and hypothermia (cold exposure) than in SCD, and was intermediate in other cases. 'Effective' and total lung aeration ratios may be useful for comparisons between specific causes of death to discriminate between hypothermia (cold exposure) and drug intoxication, and between SCD and other causes of death, respectively. These findings provide interesting insights into potential efficacy of PMCT data analyses of lung volume and CT density as well as lung air/gas content and aeration ratio with regard to the cause of death, as possible indicators of terminal respiratory function, as part of virtual autopsy of the viscera in situ. (C) 2014 Elsevier Ireland Ltd. All rights reserved.