【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 m L,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 m L,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。更多还原

【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 multilayer 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 3 D 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.更多还原