Contribution of postmortem multidetector CT scanning to identification of the deceased in a mass disaster: Experience gained from the 2009 Victorian bushfires
Contribution of postmortem multidetector CT scanning to identification of the deceased in a mass disaster: Experience gained from the 2009 Victorian bushfires
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DOI：
10.1016/j.forsciint.2010.05.026
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发表时间：
2011-02-25
影响因子：
2.2
通讯作者：
Woodford, N.
中科院分区：
文献类型：
--
作者：
O'Donnell, C.;Iino, M.;Woodford, N.
对死者进行CT扫描是一项既定的技术，在过去5年中对所有入住VIFM的人进行扫描。它主要用于协助病理学家确定死因和死亡方式，但在传统方法无法识别未知死者的情况下，它也是非常宝贵的。根据这一经验，CT扫描被纳入2009年维多利亚州火灾研究所DVI过程的第二阶段。所有被送往太平间的死者和遗骸碎片都按照既定程序在尸袋中进行了CT扫描。图像由2个团队（由2名具有法医成像经验的放射科医生组成）进行审查，并将结果转录到专门为DVI练习构建的数据表上。在火灾发生后的28天内，对255个尸袋的内容物进行了检查。164名失踪人员被纳入DVI过程，最终确定了163名死者。CT协助了161人的鉴定。在2例病例中，放射科医生无法识别混合的遗体。CT用于每个袋子内容物的初始分类。如果放射性评估确定尸体不完整，则将这一信息提供给重新访问死亡现场的搜索队。CT有助于区分8袋中的人与非人遗骸，10袋中的人/动物混合物和6袋中的人混合物。在61%的病例中，使用一种新的生殖器检测技术在CT上能够确定性别，除2例外，所有病例都是正确的。年龄范围能够确定在CT上的94%，准确性为76%。CT检测到的具体识别特征包括疾病的存在（13例病例中的14种疾病实体），医疗器械（19例病例中的26种器械）和与135人遗体相关的274种日常金属物品。CT扫描在尸检前通过标记可能的发现（包括非人类遗骸的存在）提供了有用的信息，在尸检时通过协助定位严重毁容尸体的识别特征，在尸检后通过回顾性审查图像来澄清病理学家病例审查时出现的问题。鉴于CT扫描在这场大规模灾难中的成功，DVI管理员应探索将CT服务纳入其灾难计划。(C)2010爱思唯尔爱尔兰有限公司版权所有。
CT scanning of the deceased is an established technique performed on all individuals admitted to VIFM over the last 5 years. It is used primarily to assist pathologists in determining cause and manner of death but is also invaluable for identification of unknown deceased individuals where traditional methods are not possible. Based on this experience, CT scanning was incorporated into phase 2 of the Institute's DVI process for the 2009 Victorian bushfires. All deceased individuals and fragmented remains admitted to the mortuary were CT scanned in their body bags using established protocols. Images were reviewed by 2 teams of 2 radiologists experienced in forensic imaging and the findings transcribed onto a data sheet constructed specifically for the DVI exercise. The contents of 255 body bags were examined in the 28 days following the fires. 164 missing persons were included in the DVI process with 163 deceased individuals eventually identified. CT contributed to this identification in 161 persons. In 2 cases, radiologists were unable to recognize commingled remains. CT was utilized in the initial triage of each bag's contents. If radiological evaluation determined that bodies were incomplete then this information was provided to search teams who revisited the scenes of death. CT was helpful in differentiation of human from non-human remains in 8 bags, recognition of human/animal commingling in 10 bags and human commingling in 6 bags. In 61% of cases gender was able to be determined on CT using a novel technique of genitalia detection and in all but 2 cases this was correct. Age range was able to be determined on CT in 94% with an accuracy of 76%. Specific identification features detected on CT included the presence of disease (14 disease entities in 13 cases), medical devices (26 devices in 19 cases) and 274 everyday metallic items associated with the remains of 135 individuals. CT scanning provided useful information prior to autopsy by flagging likely findings including the presence of non-human remains, at the time of autopsy by assisting in the localization of identifying features in heavily disfigured bodies, and after autopsy by retrospective review of images for clarification of issues that arose at the time of pathologist case review. In view of the success of CT scanning in this mass disaster, DVI administrators should explore the incorporation of CT services into their disaster plans. (C) 2010 Elsevier Ireland Ltd. All rights reserved.