法医学杂志

法医学杂志 ›› 2021, Vol. 37 ›› Issue (2): 215-219.DOI: 10.12116/j.issn.1004-5619.2020.400325

• 技术与应用 • 上一篇    下一篇

上颌窦积液检查在溺死诊断中的应用

陈震1， 刘晓菲2， 封华2， 唐金河2， 赵春梅2， 郭绍将3， 陈庆2， 刘力2   

  1. 1. 山西医科大学法医学院，山西 太原 030001； 2. 北京市公安局刑事侦查总队，北京 100023； 3. 北京市公安局海淀分局刑事侦查支队，北京 100192
  • 收稿日期:2020-03-26 发布日期:2021-04-25 出版日期:2021-04-28
  • 通讯作者: 刘力，男，主任法医师，主要从事法医病理学检验；E-mail：liuli0117@vip.sina.com
  • 作者简介:陈震（1993—），女，硕士研究生，主要从事法医影像学研究；E-mail：1184285904@qq.com
  • 基金资助:
    公安部“双十计划”法医学尸体虚拟解剖技术攻关项目（2019SSGG0402）

Application of Maxillary Sinus Effusion Detection in Diagnosis of Drowning

CHEN Zhen1, LIU Xiao-fei2, FENG Hua2, TANG Jin-he2, ZHAO Chun-mei2, GUO Shao-jiang3, CHEN Qing2, LIU Li2   

  1. 1. School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China; 2. Criminal Investigation Brigade of Beijing Public Security Bureau, Beijing 100023, China; 3. Detachment of Criminal Investigation, Haidian Branch of Beijing Public Security Bureau, Beijing 100192, China
  • Received:2020-03-26 Online:2021-04-25 Published:2021-04-28

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摘要： 目的 研究上颌窦积液在溺死尸体中的影像学特征，探寻其形态特点及在死因诊断中的价值，为溺死虚拟解剖研究提供客观证据支撑。 方法 收集北京市公安司法鉴定中心2019年进行死后CT检查的案例154例（溺死者31例，非溺死者123例），均经全身多层螺旋CT扫描后进行临床影像学专家双盲阅片，对影像学表现中有上颌窦积液的尸体进行上颌窦穿刺，统计上颌窦积液检出率，并在3D DICOM工作站测量上颌窦积液的CT值及积液量。 结果 溺死者上颌窦积液检出率为100%，形态为水平液面，量为1.2~11.2 mL，CT值为6.08~19.02 Hu，平均值为12.85 Hu；非溺死者上颌窦积液检出率为19.51%（24/123），形态为波浪样或毛刺形，其内可见气泡，量为0.4~13.4 mL，CT值为23.68~77.75 Hu，平均值为42.08 Hu。两者CT值差异具有统计学意义。 结论 通过死后CT检查的方法，观察和测量水中尸体上颌窦积液的形态及CT值，可作为溺死诊断的辅助检查手段。

关键词: 法医病理学, 溺死, 计算机体层成像, 上颌窦, 积液

Abstract: Objective To study the imaging characteristics of maxillary sinus effusion in drowned bodies, to explore its morphological characteristics and value in the diagnosis of the cause of death, and to provide objective evidence to support the study of virtual anatomy of drowning. Methods The 154 postmortem CT examination cases （31 cases of drowning, 123 cases of non-drowning） of Beijing Public Security Bureau Forensic Center in 2019 were collected. The bodies of all cases were scanned by multi-layer spiral CT before double-blind reading by clinical imaging experts. Maxillary sinus of corpses with maxillary sinus effusion in imaging findings was punctured. The detection rate of maxillary sinus effusion was calculated. The CT value and volume of maxillary sinus effusion were measured on 3D DICOM workstation. Results The detection rate of maxillary sinus effusion in the drowning was 100%, the shape was horizontal liquid level, the volume was 1.2-11.2 mL, the CT value was 6.08-19.02 Hu, with an average value of 12.85 Hu. The detection rate of maxillary sinus effusion in non-drowning was 19.51% （24/123）, the shape was wavy or irregular, and there were bubbles inside, the volume was 0.4-13.4 mL, the CT value was 23.68-77.75 Hu, with an average value of 42.08 Hu. The differences in CT value between the two groups had statistical significance. Conclusion The postmortem CT examination method can be used to observe the shape and measure the CT value of the maxillary sinus effusion in the bodies in water, which can be an auxiliary examination method for identification of drowning.

Key words: forensic pathology, death from drowning, computed tomography （CT）, maxillary sinus, effusion

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