Forensic Imaging最新文献

Unveiling the diagnostic accuracy of PMCT: Detection of pneumonia considering postmortem changes and time intervals

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-20 DOI: 10.1016/j.fri.2024.200617

Max G. Mentink , Bartholomeus G.H. Latten , Frans C.H. Bakers , Casper Mihl , Lisa M. Hillen , Paul A.M. Hofman

Purpose

Postmortem CT (PMCT) faces challenges in assessing lung parenchyma due to images being acquired in expiratory state, leading to varying severity of pulmonary edema redistribution with gravity-dependent attenuation ranging from ground glass to full opacification. This retrospective study assessed the effect of gravity-dependent attenuation and the postmortem time interval (PTI) on the diagnostic accuracy of PMCT for detecting acute pneumonia.

Materials and methods

Deceased patients who underwent PMCT and autopsy were included. Consensus evaluations by two radiologists and two pathologists re-examined images and histological samples of separate lung lobes. Scores were assigned for radiological and histological findings, including the presence of acute pneumonia, gravity-dependent attenuation severity, and pulmonary edema. PTI was calculated and correlated with gravity-dependent attenuation severity. Crosstabs were created to calculate diagnostic parameters.

Results

Fifty-seven patients were included, with four excluded and 44 fully opacified lung lobes. 168 lung lobes remained for analysis. The average PTI was 22 hours and 47 min. A weak correlation was observed between PTI and gravity-dependent attenuation severity (τb = 0.125, p = 0.016). Acute pneumonia prevalence was 24,4 %, with sensitivity and specificity of PMCT for all lung lobes at 31,71 % and 85,83 %, respectively. PMCT performed better in subgroups with none or slight gravity-dependent attenuation and in patients scanned within 16 hours after death.

Conclusion

Interpretation of lung parenchyma with PMCT is challenging. Statistical power was limited due to a limited sample size. PMCT is more suited for excluding acute pneumonia than detecting its presence. Prolonging PTI should be avoided, as increasing gravity-dependent attenuation severity over time limits PMCT sensitivity.

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引用次数: 0

Closed iris, long exposure photography improves three-dimensional photogrammetric bone reconstructions 闭合虹膜长曝光摄影改进了三维摄影测量骨骼重建

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-20 DOI: 10.1016/j.fri.2024.200618

Emma C. Klein, Jasmine C. Feddema, Loren Z.F. Chiu

Three-dimensional (3D) photogrammetry is being increasingly used for digital reconstruction of physical objects. There has been limited investigation on how picture quality influences 3D photogrammetric reconstructions. The purpose of this research was to experimentally compare reconstructions generated from images taken with larger versus smaller iris openings. Four cadaveric feet (2 left and 2 right) from 2 cadavers were dissected, removing skin, fascia, and muscles. Pictures were taken with the feet placed upright on a turntable. For each foot, 24 pictures were taken at f/3.2 (open iris) and f/11 (closed iris), with respective exposure time and ISO determined using a photography light meter. Bones were digitally reconstructed and the talar dome was visually compared between open versus closed iris reconstructions. Closed iris reconstructions more accurately represented the talar dome, for example having gradual and smooth curved transition between the top surface and the medial and lateral sides. Open iris reconstructions had greater distortion, such as sharp, bulging edges on these transitions. To increase the quality of 3D photogrammetric digital reconstructions, a closed iris, restricting only focused light to pass through the camera's iris to the sensor is recommended. Using a closed iris may be particularly important for bone surfaces covered with hyaline cartilage.

三维（3D）摄影测量越来越多地用于实物的数字重建。关于图片质量如何影响三维摄影测量重建的研究还很有限。这项研究的目的是通过实验比较由虹膜开口较大和较小的图像生成的重建结果。解剖了两具尸体的四只脚（两只左脚和两只右脚），去除皮肤、筋膜和肌肉。将脚直立放在转盘上进行拍照。每只脚分别以 f/3.2（打开光圈）和 f/11（关闭光圈）拍摄 24 张照片，并使用摄影测光表确定各自的曝光时间和 ISO。对骨骼进行数字重建，并目测比较开放式和封闭式光圈重建的距骨穹顶。封闭式虹膜重建更准确地表现了距骨穹隆，例如，顶面与内侧和外侧之间有渐进、平滑的曲线过渡。而开放式虹膜重建则有更大的失真，例如在这些过渡处有尖锐、隆起的边缘。为了提高三维摄影测量数字重建的质量，建议使用封闭式光圈，只允许聚焦光通过相机光圈进入传感器。对于覆盖着透明软骨的骨骼表面，使用封闭光圈可能尤为重要。

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引用次数: 0

Cranial surgical approaches in the 21st Century Identified Skeletal Collection 21 世纪的颅骨外科手术方法已鉴定的骨骼藏品

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-20 DOI: 10.1016/j.fri.2024.200616

Maria Teresa Ferreira , Catarina Coelho , Rosa Ramos Gaspar , Daniela P. de Matos , Ricardo Pereira , Eugénia Cunha , Inês Oliveira-Santos

In Forensic Anthropology, identification is comparing information from a person whose fate and whereabouts are unknown with data from a person who is present but whose identity is unknown. The rarer and more distinctive the characteristics observed during the anthropological investigation, the greater the probability of reaching an identification. Taking this into account, cranial surgeries can be considered good individualization factors. The cases of skulls with lesions compatible with surgical procedures from the 21st Century Identified Skeletal Collection are presented, and their identification potential is discussed. This collection comprises 302 adult individuals, of which four females (aged 55 to 94 years) and four males (aged 67 to 92 years) present cranial lesions of surgical origin. The results of the macroscopic and imaging analyses (conventional x-rays and CTs) are presented, along with a detailed description and location of each lesion. In five cases there is clear evidence of bone remodelling. This research, which combines anthropological analysis with imaging and neurosurgical insights, demonstrates the importance of correctly interpreting these lesions, illustrating how important is a complete and interdisciplinary analysis for forensic expertise.

在法医人类学中，辨认是将命运和下落不明者的信息与在场但身份不明者的数据进行比较。在人类学调查过程中观察到的特征越罕见、越独特，达成鉴定的可能性就越大。考虑到这一点，颅骨手术可被视为很好的个体化因素。本文介绍了 "21 世纪已确认骸骨收藏 "中带有与外科手术相符的病变的头骨案例，并讨论了它们的鉴定潜力。该收藏包括 302 个成年个体，其中四名女性（55 至 94 岁）和四名男性（67 至 92 岁）的颅骨病变源于外科手术。本文介绍了宏观和成像分析（传统 X 光和 CT）的结果，以及每个病变的详细描述和位置。在五个病例中，有明确的骨重塑证据。这项研究将人类学分析与影像学和神经外科见解相结合，证明了正确解释这些病变的重要性，说明了完整的跨学科分析对于法医专业知识的重要性。

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引用次数: 0

Exploring lightweight convolution neural networks for segmenting striation marks from firearm bullet images 探索从枪支子弹图像中分割条纹痕迹的轻量级卷积神经网络

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-13 DOI: 10.1016/j.fri.2024.200611

Genevieve Chyrmang , Barun Barua , Kangkana Bora , R. Suresh

In the field of forensic ballistic science, the identification of firearms is accomplished by examining the class and individual distinctive marks of fired bullets or cartridge casings instances discovered at the crime scene. The distinctive striation mark, which is engraved on bullets by gun barrels while firing owing to rifling, is one of the important characteristics examined. These striation marks serve as “fingerprints” of firearms. However, manual identification is time-consuming and arduous, necessitating the need for automation. This study focuses on automating striation mark segmentation using novel lightweight deep-learning segmentation models. The motivation behind this study is two-fold: first to assess if lightweight models can replace larger models without sacrificing accuracy and secondly to leverage their efficiency for resource-limited hardware, paving the way for real-time solutions. Proposed models include Mobile Striation-Net (MSN), Attention Gatted MobileStriation-Net (AMSN), Depthwise Attention Gatted Mobile Striation-Net (D-AMSN), and two derivatives of it, which are a pruned version and a quantized variant named PD-AMSN and QD-AMSN respectively. Extensive evaluation of models includes metrics Accuracy, Dice coefficient, Intersection over Union (IOU), Precision, and Recall. A thorough comparative analysis takes into account all models based on parameter counts, frames per second, inference time, and size. Findings shows, all models attains above 95% Accuracy. Dice coefficient and IOU ranges from 0.48 to 0.54 & 0.59 to 0.6 respectively. Precision and Recall consistently range between 63.42% to 64.26% and 73.6% to 77.68% respectively. The “Pruned” variant PD-AMSN performs notably better across metrics than the D-AMSN model demonstrating effective pruning. On the other hand, quantized QD-AMSN have only 6 MB size and 95.42% accuracy. Our models are positioned as forerunners in terms of lightweight design, attention gate integration, decreased parameter counts, and improved accuracy when compared to other previous models. The effectiveness of our models for segmentation tasks and their potential for developing into a portable, real-time automated striation mark segmentation systems in the future, are highlighted through the in-depth analysis.

在法医弹道学领域，枪支的鉴定是通过检查在犯罪现场发现的已发射子弹或弹壳实例的类别和个别独特标记来完成的。由于膛线的原因，枪管在发射时会在子弹上刻下明显的条纹痕迹，这是检查的重要特征之一。这些条纹可作为枪支的 "指纹"。然而，人工识别既费时又费力，因此有必要实现自动化。本研究的重点是利用新型轻量级深度学习分割模型实现条纹标记分割的自动化。这项研究的动机有两个方面：首先是评估轻量级模型是否能在不牺牲准确性的情况下取代大型模型，其次是利用其效率来解决硬件资源有限的问题，为实时解决方案铺平道路。提出的模型包括移动条纹网（MSN）、注意力锁定移动条纹网（AMSN）、深度注意力锁定移动条纹网（D-AMSN）及其两个衍生模型，即剪枝版本和量化变体，分别命名为 PD-AMSN 和 QD-AMSN。对模型的广泛评估包括准确度、骰子系数、联合交叉（IOU）、精确度和召回率等指标。全面的比较分析考虑了所有基于参数计数、每秒帧数、推理时间和大小的模型。结果表明，所有模型的准确率都在 95% 以上。骰子系数和 IOU 分别为 0.48 至 0.54 & 0.59 至 0.6。精确度和召回率分别为 63.42% 至 64.26% 和 73.6% 至 77.68%。与 D-AMSN 模型相比，"剪枝 "变体 PD-AMSN 在各项指标上的表现明显更好，这表明剪枝工作非常有效。另一方面，量化 QD-AMSN 只有 6 MB 大小，准确率却高达 95.42%。与之前的其他模型相比，我们的模型在轻量级设计、关注门集成、减少参数数量和提高准确性方面都处于领先地位。通过深入分析，我们强调了我们的模型在分割任务中的有效性，以及未来发展成为便携式实时自动条纹标记分割系统的潜力。

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引用次数: 0

Age estimation based on sternebral fusion in a sample of Egyptian population using three-dimensional computed tomography scanning 利用三维计算机断层扫描技术，根据埃及人口样本的胸骨融合度估算年龄

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-10 DOI: 10.1016/j.fri.2024.200613

Mona M. Ghonem , Basma S. Eldeeb , Ashraf M. Elaggan , Heba I. Lashin

Objectives

Age estimation is a critical medico-legal issue in forensic medicine and sternebral fusion is recently supposed to be a helpful tool. Multidetector computed tomography (MDCT) scanning could provide three-dimensional (3D) imaging of the sternebral fusion. This study aimed to develop age estimation models based on the sternebral fusion state using MDCT scanning in a sample of Egyptians.

Material and Methods

The study included thoracic MDCT images of 261 Egyptians. The stage of sternebral fusion was evaluated in the 3D reconstructed images generated using Vitrea® software. Fusion between sternebrae 1&2, sternebrae 2&3, and sternebrae 3&4 were staged as non-fusion, partial fusion, and complete fusion. Scores 1, 2, and 3 were given to the three stages, respectively and their sum was the total sternebral fusion score.

Results

Significant positive correlations were observed between all sternebral fusions and the participants’ chronological age. Stages of sternebral fusion significantly contributed to age estimation using simple and multiple linear regression models (P < 0.001 for each). Using calibration curves, the total sternebral fusion score and the multivariate models had the best performance to predict the chronological age. At cut-off > 6, total sternebral fusion score was an excellent predictor for the age of 18 with areas under the curve = 0.943 and 0.952, in females and males respectively.

Conclusion

The developed models based on sternebral fusion stages can be used for forensic age estimation in the studied Egyptian sample. A total sternebral fusion score > 6 efficiently distinguished those aged 18 years.

目标年龄估算是法医学中一个关键的医学法律问题，而最近的研究认为立体骨融合是一种有用的工具。多载体计算机断层扫描（MDCT）可提供立体（3D）成像。本研究旨在通过对埃及人样本进行 MDCT 扫描，根据其胸骨融合状态建立年龄估计模型。使用 Vitrea® 软件生成的三维重建图像对胸骨融合的阶段进行了评估。胸骨 1&2、胸骨 2&3 和胸骨 3&4 之间的融合分为未融合、部分融合和完全融合。结果发现，所有立体骨融合与受试者的实际年龄呈显著正相关。使用简单和多元线性回归模型（各模型的 P 均为 0.001）进行年龄估算时，各阶段的立体骨融合均有明显作用。利用校正曲线，胸骨融合总分和多元模型在预测实际年龄方面表现最佳。在截断值为 6 时，女性和男性的胸骨融合总分曲线下面积分别为 0.943 和 0.952，是预测 18 岁的最佳指标。胸骨融合总分大于 6 分可有效区分 18 岁人群。

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引用次数: 0

Flaring up the mesentery: Applying the LODOX eXero-DR® statscan for expedited postmortem angiography. 翻开肠系膜：应用 LODOX eXero-DR® statscan 快速进行死后血管造影。

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-09 DOI: 10.1016/j.fri.2024.200614

Zandré Smith , Elrinda de Bruin , Ilze Mentoor , Janette Verster

Rationale

The affordable LODOX eXero-DR® statscan aids Forensic Pathologists in resource-constrained settings. Post-mortem angiography using LODOX eXero-DR® assists in detecting vascular pathology, therefore enhancing routine autopsies.

Objective

Demonstrating the feasibility of performing postmortem angiography using the LODOX eXero-DR® statscan.

Methods

We present a case of a 63-year-old male with follicular lymphoma who experienced small bowel perforation 11 days after a mesenteric lymph node biopsy.

Results

A post-mortem examination confirmed lymphadenopathy and bowel perforation, prompting an investigation into the underlying cause. During the post-mortem, the mesentery was excised, exposing the Superior Mesenteric Artery origin. Contrast medium was injected into the artery using a Foley catheter in 5 ml increments, followed by LODOX eXero-DR® imaging. This process was repeated five times, pinpointing the vascular obstruction site. Angiography with LODOX eXero-DR® yielded vital information, aiding pathology identification and record creation.

Conclusion

This case demonstrates the potential of angiography with emerging technologies, assisting countries lacking access to PMCT angiography. Notably, this represents the inaugural documentation of LODOX eXero-DR® statscan use in post-mortem angiography.

理由经济实惠的 LODOX eXero-DR® statscan 扫描仪可在资源有限的环境中为法医病理学家提供帮助。使用 LODOX eXero-DR® 进行死后血管造影有助于检测血管病变，从而提高常规尸检的效率。方法我们展示了一例患有滤泡性淋巴瘤的 63 岁男性病例，他在肠系膜淋巴结活检 11 天后出现小肠穿孔。在尸检过程中，切除了肠系膜，露出了肠系膜上动脉源头。使用 Foley 导管将造影剂以 5 毫升为单位注入动脉，然后进行 LODOX eXero-DR® 成像。此过程重复五次，准确定位血管阻塞部位。使用 LODOX eXero-DR® 进行血管造影获得了重要信息，有助于病理鉴定和建立病历。值得注意的是，这是 LODOX eXero-DR® statscan 首次用于尸检血管造影。

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引用次数: 0

Feasibility of new thresholds for coronary artery calcium score using low-tube voltage protocols in postmortem computed tomography1 死后计算机断层扫描中使用低管电压协议进行冠状动脉钙化评分的新阈值的可行性1

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-09 DOI: 10.1016/j.fri.2024.200615

Kyoung Eun Cheon , Se-min Oh , Sung Wook Choi , Man-Seok Han , Jang Gyu Cha , Heon Lee , Minju Lee , Sookyoung Lee

Objective

To validate whether low tube voltage scans of 100 kilovolt-peak (kVp) and 80 kVp for measuring coronary artery calcium score (CACS) using computed tomography (CT) yield comparable results to the standard protocol of 120 kVp using postmortem CT (PMCT).

Materials and Methods

We obtained scans for cadavers where CAC was observed on PMCT scans. In addition to the standard protocol, tube voltage scans were also obtained under conditions of 100 kVp and 80 kVp. We obtained a newly adapted threshold under low tube voltage and compared them with the standard protocol.

Results

The CACS was 851±1421 (p=0.99) and 861±1433 (p=0.99) for the 120-kVp and 100-kVp scans, respectively, and 845±1390 (p=0.99) for the 80-kVp scan using the newly adapted threshold. The 120-kVp and 100-kVp scans demonstrated an almost perfect correlation (r=0.99996, p<0.0001). In the Bland–Altman analysis, the 9 5% limits of agreement ranged from -44 to 25. Similarly, the CACS obtained using the adapted threshold for the 80-kVp scan also demonstrated an excellent correlation with the standard 120-kVp scan (r=0.99993, p<0.0001). In the Bland–Altman analysis, the 95 % limits of agreement ranged from -62 to 75. The effective radiation dose was 2.21±0.064 mSv (p<0.0001) for the 120-kVp scan, 1.35±0.070 mSv (p<0.0001) for the 100-kVp scan, and 0.72±0.48 mSv (p<0.0001) for the 80-kVp scan.

Conclusion

This study suggests that PMCT can be used to measure CACS at low tube voltages and that significant dose reductions in patients can be expected in clinical practice.

目的验证使用计算机断层扫描（CT）测量冠状动脉钙化评分（CACS）时，100 千伏-峰值（kVp）和 80 千伏-峰值（kVp）的低管电压扫描结果是否与使用尸检 CT（PMCT）测量 120 千伏-峰值（kVp）的标准方案结果相当。除标准方案外，我们还在 100 kVp 和 80 kVp 的条件下进行了管电压扫描。结果120 kVp和100 kVp扫描的CACS分别为851±1421（P=0.99）和861±1433（P=0.99），使用新调整的阈值进行80 kVp扫描的CACS为845±1390（P=0.99）。120-kVp 和 100-kVp 扫描显示出几乎完美的相关性（r=0.99996，p<0.0001）。在 Bland-Altman 分析中，9.5% 的一致性范围在-44 到 25 之间。同样，使用 80 kVp 扫描的适应阈值获得的 CACS 与标准 120 kVp 扫描也显示出极好的相关性（r=0.99993，p<0.0001）。在 Bland-Altman 分析中，95 % 的一致性范围为 -62 至 75。120 kVp 扫描的有效辐射剂量为 2.21±0.064 mSv（p<0.0001），100 kVp 扫描的有效辐射剂量为 1.35±0.070 mSv（p<0.0001），80 kVp 扫描的有效辐射剂量为 0.72±0.48 mSv（p<0.0001）。

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引用次数: 0

Effects of carbonization on gunshot residue detection in an animal model 碳化对动物模型枪弹残留物检测的影响

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-11-04 DOI: 10.1016/j.fri.2024.200612

Charbel El Khoury Moussa , Bruno Payré , Sébastien Aries , Stéphane Grill , Sarah Galland , Lise Pestourie , Fabrice Dedouit , Norbert Telmon , Fréderic Savall , Céline Guilbeau-Frugier

The detection of gunshot residue (GSR) can be useful to determine if the wound has been caused by a firearm and it could help to differentiate the entry wound from the exit one. Carbonization is a good method for altering crime scenes. However, there are few studies in this specific context. The first objective of our study was to examine the persistence of GSR in wounds after carbonization. The second aim was to differentiate entry wounds from exit ones.

For the experiment, bullets were fired with a 22LR on sheep limbs at contact range.

The specimens were divided into four groups: two that weren't shot at (fresh and carbonized limbs) and two of shot limbs (one with carbonization and one without). Carbonization was performed in the open air using an accelerant.

Wounds were analyzed using Scanning Electron Microscopy with Energy Dispersive X-ray spectrometry (SEM–EDX) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS).

Lead, Antimony and Barium were observed using SEM-EDX only in the entry wounds, while lead was found in the exit ones. ICP-MS enabled the detection of these elements in the entry and exit wounds but predominantly in the entry ones. After carbonization we observed a huge decrease of GSR. With SEM-EDX most of the particles detected were only consistent with GSR. Anyway, the identification of GSR and the differentiation between entry and exit wounds were still possible with both techniques. Therefore, they are suitable for detecting GSR in carbonized gunshot wounds under the specific conditions of our experiment.

检测枪击残留物（GSR）有助于确定伤口是否由枪支造成，也有助于区分入口伤口和出口伤口。碳化是改变犯罪现场的一种好方法。然而，针对这一特定情况的研究却很少。我们研究的第一个目的是检查碳化后伤口中 GSR 的持久性。在实验中，用 22LR 子弹在接触范围内射击绵羊肢体。标本被分为四组：两组未中弹（新鲜肢体和碳化肢体），两组中弹肢体（一组碳化，一组未碳化）。使用扫描电子显微镜与能量色散 X 射线光谱法（SEM-EDX）和电感耦合等离子体质谱法（ICP-MS）对伤口进行了分析。使用扫描电子显微镜与能量色散 X 射线光谱法（SEM-EDX）仅在入口伤口中观察到铅、锑和钡，而在出口伤口中发现了铅。ICP-MS 能够在入口和出口伤口中检测到这些元素，但主要是在入口伤口中。碳化后，我们观察到 GSR 大幅下降。通过 SEM-EDX 检测到的大部分颗粒与 GSR 一致。无论如何，这两种技术仍然可以识别 GSR 并区分入口和出口伤口。因此，在我们实验的特定条件下，这两种技术都适用于检测碳化枪伤中的 GSR。

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引用次数: 0

Decreased hepatic CT value on immediate postmortem CT after CPR: Comparison with antemortem CT and correlation with liver enzymes changes 心肺复苏术后立即尸检的肝脏 CT 值下降：与死前CT的比较以及与肝酶变化的相关性

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-10-22 DOI: 10.1016/j.fri.2024.200609

Tomoaki Hagita , Seiji Shiotani , Kento Inoue , Yukio Kosako , Yasuji Matsuno

Purpose We compared hepatic antemortem CT (AMCT) and postmortem CT (PMCT) values obtained in the same subjects. The correlations between the changes in hepatic CT values and changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) values were also investigated.

Materials and methods Fifty subjects (20 males, 30 females; mean age: 85.9 ± 7.9 years; range: 67–100 years) who were transported to the emergency room in cardiopulmonary arrest (CPA) and underwent PMCT immediately after unsuccessful cardiopulmonary resuscitation (CPR) comprised the study population. The hepatic AMCT and PMCT values were both measured, and the differences between the two were calculated. The differences between AST, ALT, and LDH values at CPR and antemortem were also calculated. The correlations between the hepatic CT value differences and AST, ALT, and LDH value differences also were assessed.

Results The hepatic AMCT and PMCT values of 61.7 ± 6.8 Hounsfield Unit (HU) and 46.2 ± 8.2 HU, respectively, were significantly different. The AST, ALT, and LDH values were significantly higher at CPR than at antemortem. The differences in the hepatic CT values and in the AST, ALT, and LDH values were moderately correlated.

Conclusion The hepatic values were significantly lower on PMCT than on AMCT. The changes in hepatic CT values correlated with the changes in the liver deviation enzyme values. These results indicate the possibility that ischemic, hypoxic injury, and anerobic glycolysis of the liver at CPR after CPA are the cause of decreased hepatic PMCT values.

目的我们比较了同一受试者的肝脏死前 CT（AMCT）和死后 CT（PMCT）值。材料和方法 50 名受试者（男性 20 人，女性 30 人；平均年龄：85.心肺复苏（CPR）失败后立即接受 PMCT。研究人员同时测量了肝脏 AMCT 和 PMCT 值，并计算了两者之间的差异。还计算了心肺复苏时和死前的 AST、ALT 和 LDH 值之间的差异。结果肝脏 AMCT 值为 61.7 ± 6.8 Hounsfield Unit (HU)，PMCT 值为 46.2 ± 8.2 HU，两者差异显著。心肺复苏时的 AST、ALT 和 LDH 值明显高于死前。结论 PMCT 的肝功能值明显低于 AMCT。肝 CT 值的变化与肝偏差酶值的变化相关。这些结果表明，CPA 后心肺复苏时肝脏缺血、缺氧损伤和无氧糖酵解可能是导致肝脏 PMCT 值下降的原因。

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引用次数: 0

Predictive value of coronary artery calcium score on radiological and autoptic findings in cases of sudden death 冠状动脉钙化评分对猝死病例放射学和自体检查结果的预测价值

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging

Pub Date : 2024-10-22 DOI: 10.1016/j.fri.2024.200610

Jessika Camatti , Anna Laura Santunione , Stefano Draisci , Drago Antonella , Maria Grazia Amorico , Guido Ligabue , Enrico Silingardi , Pietro Torricelli , Rossana Cecchi

Calcium Artery Coronary Score (CACS) is a noninvasive examination of the coronary arteries in which the amount of calcium is calculated using cardiac Computed Tomography. The role of postmortem imaging in sudden death has been the subject of increasing interest in recent years, and previous studies have proposed a possible correlation between CACS and autopsy findings.

The present study aims to establish a correlation between CACS, the presence of coronary artery opacification defects on Multi-Phase Post-Mortem Computed Tomography Angiography (MPMCTA), and the presence of coronary stenosis at autopsy, in order to verify whether CACS confirms its predictive value in terms of cardiac risk and can guide the decision to perform or not to perform MPMCTA.

A cohort of 24 subjects who died suddenly was examined. Firstly, MPMCTA was performed, then autopsy was carried out. CACS was calculated, the detection of opacification defects on MPMCTA was investigated and the presence of coronary stenoses on autopsy was described.

24 deceased individuals (53 years ± 11.7; 20 men) were evaluated. CACS has a positive predictive value of 0.78 and a negative predictive value of 0.73 in assessing the presence of radiological coronary artery opacification defects. The positive predictive value on stenosis relief is 0.88, while the negative predictive value on the same relief is 0.73.

CACS is an appropriate additional tool in the evaluation of sudden death cases. Our results provided an encouraging contribution to the systematic application of CACS in cases of sudden death.

冠状动脉钙化评分（CACS）是通过心脏计算机断层扫描计算冠状动脉钙化量的一种无创检查。近年来，尸检成像在猝死中的作用越来越受到关注，之前的研究提出了 CACS 与尸检结果之间可能存在的相关性。本研究旨在建立CACS、多相死后计算机断层扫描血管成像（MPMCTA）中出现的冠状动脉不透明缺陷与尸检时出现的冠状动脉狭窄之间的相关性，以验证CACS是否证实了其在心脏风险方面的预测价值，并能指导是否进行MPMCTA的决定。首先进行 MPMCTA，然后进行尸检。对 24 名死者（53 岁 ± 11.7；20 名男性）进行了评估。在评估是否存在放射学冠状动脉不透明缺陷方面，CACS 的阳性预测值为 0.78，阴性预测值为 0.73。在评估猝死病例时，CACS 是一个合适的补充工具。我们的研究结果为在猝死病例中系统应用 CACS 做出了令人鼓舞的贡献。

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