法医学杂志

法医学杂志 ›› 2020, Vol. 36 ›› Issue (1): 72-76.DOI: 10.12116/j.issn.1004-5619.2020.01.015

• 技术与应用 • 上一篇    下一篇

虚拟解剖技术在医疗纠纷尸体检验中的应用

金馨1，2，3， 赵建新1，2， 姚艺1，2， 黄俊杰1，2， 张峰2， 李兴彪1，2， 叶光华1，2， 范琰琰1，2， 黄定品4， 夏能志4， 邹冬华5， 刘宁国5， 喻林升1，2   

  1. 1. 温州医科大学法医学系，浙江 温州 325035； 2. 温州医科大学司法鉴定中心，浙江 温州 325035； 3. 嘉兴学院医学院病理与法医学教研室，浙江 嘉兴 314001； 4. 温州医科大学附属第一医院，浙江 温州 325015； 5. 司法鉴定科学研究院 上海市法医学重点实验室 司法部司法鉴定重点实验室 上海市司法鉴定专业技术服务平台，上海 200063
  • 发布日期:2020-02-25 出版日期:2020-02-28
  • 通讯作者: 喻林升，男，博士，教授，主要从事法医病理学研究；E-mail：yls@wmu.edu.cn 刘宁国，男，研究员，主任法医师，主要从事法医病理学研究；E-mail：liuningguo@yahoo.com.cn
  • 作者简介:金馨（1993—），女，硕士，主要从事法医病理学研究；E-mail：jinxin_2016@126.com
  • 基金资助:
    “十三五”国家重点研发计划资助项目（2016YFC0800702）；上海市法医学重点实验室资助项目（17DZ2273200）；上海市司法鉴定专业技术服务平台资助项目（19DZ2292700）

Application of Virtual Anatomy Technology in Postmortem Examination of Medical Dispute Cases

JIN Xin1,2,3, ZHAO Jian-xin1,2, YAO Yi1,2, HUANG Jun-jie1,2, ZHANG Feng2, LI Xing-biao1,2, YE Guang-hua1,2, FAN Yan-yan1,2, HUANG Ding-pin4, XIA Neng-zhi4, ZOU Dong-hua5, LIU Ning-guo5, YU Lin-sheng1,2   

  1. 1. Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China; 2. Judicial Forensic Center, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China; 3. Department of Pathology and Forensic Medicine, Jiaxing University Medical College, Jiaxing 314001, Zhejiang Province, China; 4. The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, Zhejiang Province, China; 5. Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
  • Online:2020-02-25 Published:2020-02-28

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摘要： 目的 探讨CT扫描技术在医疗纠纷死亡原因鉴定中的应用价值。 方法 在2017年7月至2018年12月间，对12例医疗纠纷案例行全身CT检验，比较CT影像诊断与解剖所见及生前与死后CT诊断的差异性，分析尸体的CT常规检验在病变与损伤的诊断方面的优势与劣势。 结果 CT影像诊断与解剖所见比较显示，在密度改变差异大的病变和损伤的诊断方面CT检验存在优势，如肺不张、肺炎、钙化、骨折、出血等；生前与死后CT诊断的比较显示医疗纠纷案件的尸体保存都较为良好，死后CT扫描检验对生前疾病诊断具有意义。 结论 虚拟解剖技术在医疗纠纷尸体检验中有较高的应用价值，可在尸体解剖前为鉴定人提供有效信息，也可在无法进行解剖的情况下为死亡原因分析提供参考依据。

关键词: 法医病理学；虚拟解剖；体层摄影术, 螺旋计算机；尸体解剖；死亡原因；医疗纠纷

Abstract: Objective To discuss the application value of CT scanning technology in cause of death determination of medical dispute cases. Methods From July 2017 to December 2018, postmortem CT imaging data of 12 medical dispute cases were collected. CT imaging diagnosis results and anatomy findings as well as differences between antemortem and postmortem CT diagnosis were compared. The advantages and disadvantages of CT routine tests of the cadavers in terms of the diagnosis of disease and damage were analyzed. Results The comparison between CT imaging diagnosis and anatomical findings showed that CT scans had advantages in the diagnosis of disease and damage with large differences in density changes, such as atelectasis, pneumonia, calcification, fracture and hemorrhage, etc. The comparison of CT diagnosis in antemortem and postmortem examination showed that the cadavers of medical dispute cases were well preserved and that postmortem CT scan was meaningful for the diagnosis of antemortem diseases. Conclusion Virtual anatomy technology has a relatively high application value in postmortem examination of medical dispute cases. It can provide effective information for the appraisers before the autopsy and can also provide a reference for cause of death analysis when the anatomy cannot be performed.

Key words: forensic pathology, virtual anatomy, tomography, spiral computed, autopsy, cause of death, medical dispute