Virtual Autopsy Morphological Features of Drowning

doi:10.12116/j.issn.1004-5619.2021.410806

Abstract

Abstract: Objective

To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning.

Methods

In this study, 7 corpses were selected as the research objects. The image data of corpses were collected by computed tomography （CT） before conventional autopsy. The characteristics of corpses were observed through image reading, combined with virtual measurement indexes, and compared with 15 non-drowned corpses.

Results

The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning， and ground-glass opacities in the lung. The statistical volume of fluid in the sinus （maxillary sinus and sphenoid sinus） was （10.24±4.70） mL in drowning cases and （2.02±2.45） mL in non-drowning cases. The average CT value of fluid in the sinus， left atrial blood and gastric contents in drowning cases were （15.91±17.20）, （52.57±9.24） and （10.33±12.81） HU， respectively， which were lower than those in non-drowning cases （P<0.05）.

Conclusion

The comprehensive consideration of multiple characteristic image manifestations and the virtual measurement indexes are helpful to the forensic pathological diagnosis of drowning. Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.

Key words: forensic pathology, drowning, virtual autopsy, computed tomography, sinus effusion, respiratory effusion

CLC Number:

DF795.1

Jun-qi JIAN, Dong-hua ZOU, Zheng-dong LI, Jian-hua ZHANG, Zhi-qiang QIN, Ning-guo LIU. Virtual Autopsy Morphological Features of Drowning[J]. Journal of Forensic Medicine, 2022, 38(1): 53-58.

Figures/Tables 6

References 12

1	FILOGRANA L， FLACH P M， BOLLIGER S A， et al. The role of post-mortem CT （PMCT） imaging in the diagnosis of pericardial tamponade due to hemopericardium：A case report[J]. Leg Med，2014，16（3）：150-153. doi：10.1016/j.legalmed.2014.02.004 .
2	FILOGRANA L， HATCH G， RUDER T， et al. The role of post-mortem imaging in a case of sudden death due to ascending aorta aneurysm rupture[J]. Forensic Sci Int，2013，228（1/2/3）：e76-e80. doi：10.1016/j.forsciint.2013.01.039 .
3	陈忆九. 虚拟解剖技术的应用研究进展[J]. 法医学杂志，2014，30（5）：360-366. doi：10.3969/j.issn.1004-5619.2014.05.012 .
	CHEN Y J. Research development and application of virtopsy[J]. Fayixue Zazhi，2014，30（5）：360-366.
4	赵子琴. 法医病理学[M].4版. 北京：人民卫生出版社，2009.
	ZHAO Z Q. Forensic pathology[M]. 4th ed. Beijing： People’s Medical Publishing House， 2009.
5	AGHAYEV E， THALI M J， SONNENSCHEIN M， et al. Fatal steamer accident; blunt force injuries and drowning in post-mortem MSCT and MRI[J]. Forensic Sci Int，2005，152（1）：65-71. doi：10.1016/j.forsciint.2005.02.034 .
6	KAWASUMI Y， KAWABATA T， SUGAI Y， et al. Assessment of the relationship between drowning and fluid accumulation in the paranasal sinuses on post-mortem computed tomography[J]. Eur J Radiol，2012，81（12）：3953-3955. doi：10.1016/j.ejrad.2012.08.011 .
7	PLAETSEN S V， DE LETTER E， PIETTE M， et al. Post-mortem evaluation of drowning with whole body CT[J]. Forensic Sci Int，2015，249：35-41. doi：10.1016/j.forsciint.2015.01.008 .
8	万雷，郑剑，应充亮，等. 多层螺旋CT虚拟解剖判定溺死1例[J]. 法医学杂志，2010，26（6）：469-471. doi：10.3969/j.issn.1004-5619.2010.06.020 .
	WAN L， ZHENG J， YING C L， et al. Virtual anatomical determination of drowning by multislice computed tomography： A case report[J]. Fayixue Zazhi，2010，26（6）：469-471.
9	LUNETTA P， MODELL J H， SAJANTILA A. What is the incidence and significance of “dry-lungs” in bodies found in water?[J]. Am J Forensic Med Pathol，2004，25（4）：291-301. doi：10.1097/01.paf.0000146240.92905.7e .
10	LIN C Y， YEN W C， HSIEH H M， et al. Diatomological investigation in sphenoid sinus fluid and lung tissue from cases of suspected drowning[J]. Forensic Sci Int，2014，244：111-115. doi：10.1016/j.forsciint.2014.08.023 .
11	LEVY A D， HARCKE H T， GETZ J M， et al. Virtual autopsy： Two- and three-dimensional multidetector CT findings in drowning with autopsy comparison[J]. Radiology，2007，243（3）：862-868. doi：10.1148/radiol.2433061009 .
12	BATTISTA G， SASSI C， ZOMPATORI M， et al. Ground-glass opacity： Interpretation of high resolution CT findings[J]. Radiol Med，2003，106（5/6）：425-442， quiz443-444.

案例	性别	年龄/岁	落水地	尸体发现至虚拟解剖时间	尸体现象	水体
1	男	44	泵池	3 h	新鲜尸体，未见腐败征象	生活用水
2	男	39	河道	57 h	冰冻后缓解尸体，轻度腐败	河水
3	女	18	河道	17 d	冰冻后缓解尸体，轻度腐败	河水
4	男	54	蓄水池	5 d	冰冻后缓解尸体，轻度腐败	生活用水
5	女	40	河道	10 d	冰冻后缓解尸体，轻度腐败	河水
6	男	38	河道	6 h	新鲜尸体，未见腐败征象	河水
7	女	28	河道	5 d	冰冻后缓解尸体，轻度腐败	河水

案例	性别	年龄/岁	落水地	尸体发现至虚拟解剖时间	尸体现象	水体
1	男	44	泵池	3 h	新鲜尸体，未见腐败征象	生活用水
2	男	39	河道	57 h	冰冻后缓解尸体，轻度腐败	河水
3	女	18	河道	17 d	冰冻后缓解尸体，轻度腐败	河水
4	男	54	蓄水池	5 d	冰冻后缓解尸体，轻度腐败	生活用水
5	女	40	河道	10 d	冰冻后缓解尸体，轻度腐败	河水
6	男	38	河道	6 h	新鲜尸体，未见腐败征象	河水
7	女	28	河道	5 d	冰冻后缓解尸体，轻度腐败	河水

观测指标	溺死组		对照组
观测指标	n	测量值	n	测量值
鼻窦积液量^1）/mL	7	10.24±4.70^2）	15	2.02±2.45
鼻窦积液CT值/HU	14^3）	15.91±17.20^2）	16^3）	37.33±18.50
左房心血平均CT值/HU	7	52.57±9.24^2）	15	71.27±7.50
胃内容物CT值/HU	7	10.33±12.81^2）	15	41.12±18.68

观测指标	溺死组		对照组
观测指标	n	测量值	n	测量值
鼻窦积液量^1）/mL	7	10.24±4.70^2）	15	2.02±2.45
鼻窦积液CT值/HU	14^3）	15.91±17.20^2）	16^3）	37.33±18.50
左房心血平均CT值/HU	7	52.57±9.24^2）	15	71.27±7.50
胃内容物CT值/HU	7	10.33±12.81^2）	15	41.12±18.68

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