使用计算机断层扫描结果诊断活人刺伤的可能性

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目前计算机和磁共振成像等现代研究方法已被引入大型医院的医疗和诊断实践中。这些研究方法几乎在所有地方都被用于诊断各种类型的伤害,其结果连同受伤者的医疗文件,由执法人员和法院提交给国家法医机构进行法医检验。对计算机和磁共振成像结果的研究使您能够解决活人检查和研究案例中的专家问题。

本文介绍了一个专家实践案例,展示了利用活体计算机断层扫描和三维建模的结果确定刺伤的形态特征和定位、创伤效应的数量和伤口通道方向的可能性。在所描述的专家案例中,提交的医疗文件最初包含关于受害人伤口的数量、位置和形成机制的相互矛盾的信息。为消除存在的矛盾,入院时对受害人身上的伤疤进行了检查,并在医疗机构对受害人进行了CT扫描。为了更完整地可视化外部伤害,根据计算机断层扫描数据重建了受害者身体的三维模型。作为这项研究的结果,有可能清楚地重现受害者所受伤害的画面,并回答有关他们造成伤害的机制和条件的问题。

所描述的案例展示了专家研究和解决法医问题的新方法的可能性,这是目前非常相关的,因为近年来,法医学一直在积极开发尸体验尸技——virtopsy。文章中描述的研究方法可以应用于带有刺伤的尸体,这可能会更准确地显示伤口通道的方向和形状。

作者简介

Sergey V. Leonov

Chief State Center for Forensic Medicine and Forensic Expertise 111; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

编辑信件的主要联系方式.
Email: sleonoff@inbox.ru
ORCID iD: 0000-0003-4228-8973
SPIN 代码: 2326-2920

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, 3, Hospital square, Moscow, 105094; Moscow

Pavel V. Pinchuk

Chief State Center for Forensic Medicine and Forensic Expertise 111; The Russian National Research Medical University named after N.I. Pirogov

Email: pinchuk1967@mail.ru
ORCID iD: 0000-0002-0223-2433
SPIN 代码: 7357-3038

MD, Dr. Sci. (Med.), Associate Professor

俄罗斯联邦, 3, Hospital square, Moscow, 105094; Moscow

Juliya P. Shakiryanova

Chief State Center for Forensic Medicine and Forensic Expertise 111; Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Email: tristeza_ul@mail.ru
ORCID iD: 0000-0002-1099-5561
SPIN 代码: 1429-6230

MD, Dr. Sci. (Med.)

俄罗斯联邦, 3, Hospital square, Moscow, 105094; Moscow

Vladimir N. Troyan

Main Military Clinical Hospital named after academical N.N. Burdenko

Email: vtroyan10@yahoo.com
ORCID iD: 0000-0002-8008-9660
SPIN 代码: 4937-3162

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Moscow

参考

  1. Shakiryanova YP, Leonov SV, Kurbanov S.I. Possibilities of computed tomography in forensic medical research. In: Selected issues of forensic medical examination: Collection of articles. Ed. by A.I. Avdeev, I.V. Vlasyuk, A.V. Nesterov. Khabarovsk; 2019. Р. 201–205. (In Russ).
  2. Andenmatten MA, Thali MJ, Kneubuehl BP, et al. Gunshot injuries detected by post-mortem multislice computed tomography (MSCT): a feasibility study. Legal Med (Tokyo). 2008;10(6):287–292. doi: 10.1016/j.legalmed.2008.03.005
  3. Dadabaev VK, Troyan VN. Use of spiral computer tomography in forensic medical practice. Medical Expertise Law. 2011;(2):36–39. (In Russ).
  4. Dadabaev VK, Alekseev RK, Romadanovsky OP, et al. The role of radiation research methods in the diagnosis and establishment mechanism of childhood injuries. Tver Medical Journal. 2019;(5):62–71. (In Russ).
  5. Klevno VA, Chumakova JV. Virtopsia--a new research method in the domestic practice of forensic medicine. In: Topical issues of Forensic medicine and expert practice: Abstracts of the reports of the International Congress, April 17-19. Moscow; 2019. Р. 46. (In Russ).
  6. Thali MJ, Braun M, Buck U, et al. Virtopsy--Scientific documentation, reconstruction and animation in forensic: individual and real 3D data based geo-metric approach including optical body/ object surface and radiological CT/MRI scanning. J Forensic Sci. 2005;50(2):428–442.

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2. Fig. 1. The direction and features of the wound channels of stab wounds according to computed tomography studies of the victim M.: а ― penetrating damage to the abdominal cavity on the right (arrow); b ― penetrating damage to the abdominal cavity in the mesogastrium (arrow).

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3. Fig. 2. Computed tomography data of the victim M.: а ― atelectasis of the left lung along the course of the wound canal; b ― marking of the displacement of the wound canal on layered images.

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4. Fig. 3. A three-dimensional model of the torso of the victim M., constructed according to the results of computed tomography, with localization of stab-cut injuries.

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