Медицинская литература. Новинки

 

 

 

 

 

 

Посмертная компьютерная томография мертворожденных с костной патологией

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Представлены данные литературы и собственные наблюдения применения спиральной КТ (СКТ) для анализа тел мертворожденных. Отмечены положительные моменты и трудности при проведении посмертной СКТ. Приведены наблюдения выкидыша и антенатальной гибели плода с врожденными аномалиями развития костной системы. Показана высокая эффективность посмертной КТ тел мертворожденных, позволяющая провести объективный и четкий анализ костной патологии, в том числе за счет создания 3D-реконструкций. Сделан вывод о целесообразности проведения в определенных случаях посмертной СКТ как дополнения к патологоанатомическому или судебномедицинскому исследованию.

Ключевые слова:
посмертная компьютерная томография, мертворожденный, аутопсия.

Литература:
1. Щёголев А.И., Павлов К.А., Дубова Е.А., Фролова О.Г. Мертворождаемость в субъектах Российской
Федерации в 2010 году. Арх. пат. 2013; 2: 20–24.
2. Gordijn S.J., Erwich J.J., Khong T.Y. Value of the perinatal
autopsy: critique. Pediatr. Dev. Pathol. 2002; 5: 480–488.
3. Amini H., Antonsson P., Papadogiannakis N. et al.
Comparison of ultrasound and autopsy findings in pregnancies terminated due to fetal anomalies. Acta Obstet.
Gynecol. Scand. 2006; 85: 1208–1216.
4. Sankar V.H., Phadke S.R. Clinical utility of fetal autopsy
and comparison with prenatal ultrasound findings.
J. Perinatol. 2006; 26: 224–229.
5. Akgun H., Basbug M., Ozgun M.T. et al. Correlation
between prenatal ultrasound and fetal autopsy findings in
fetal anomalies terminated in the second trimester.
Prenat. Diagn. 2007; 27: 457–462.
6. Павлов К.А., Дубова Е.А., Бурдули Г.М. и др. Мацерация плода. Акуш. и гин. 2012; 2: 115–119.
7. Thayyil1 S., Chitty L.S., Robertson N.J. et al. Minimally
invasive fetal postmortem examination using magnetic
resonance imaging and computerised tomography: cur
rent evidence and practical issues. Prenat. Diagn.
2010; 30: 713–718.
8. Ezawa H., Shiotani S., Uchigasaki S. Autopsy imaging in
Japan. Rechtsmedizin. 2007; 17: 19–20.
9. Brueschweiler W., Braun M., Fuchser H.J., Dirn
hofer R. Photogrammetrische Auswertung von Haut und
Weichteilwunden sowie Knochenverletzungen zur Bestimmung des Tatwerkzeuges: grundlegende Aspekte.
Rechtsmedizin. 1997; 7: 1976–1983.
10. Thali M.J., Yen K., Schweizer W. et al. Virtopsy, a new
imaging horizon in forensic pathology: virtual autopsy by
postmortem multislice computed tomography (MSCT)
and magnetic resonance imaging (MRI) – a feasibility
study. J. Forensic. Sci. 2003; 48: 386–403.
11. Dirnhofer R., Jackowski C., Vock P. et al. VIRTOPSY: mini
mally invasive, imagingguided virtual autopsy.
RadioGraphics. 2006; 26: 1305–1333.
12. Hamano J., Shiotani S., Yamazaki K. et al. Postmortem
computed tomographic (PMCT) demonstration of fatal
hemoptysis by pulmonary tuberculosis – radiological
pathological correlation in a case of rupture of
Rasmussen's aneurysm. Radiat. Med. 2004; 22: 120–122.
13. Shiotani S., Kohno M., Ohashi N. et al. Nontraumatic
postmortem computed tomographic (PMCT) findings of
the lung. Forensic. Sci. Int. 2004; 139: 39–48.
14. The Royal College of Radiologists and the Royal College
of Pediatrics and Child Health. Standards for radiological
investigations of suspected nonaccidental injury. 2008.
Available via http://www.rcr.ac.uk/docs/radiology/pdf/
RCPCH_RCR_final.pdf. Accessed 13 Nov. 2009.
15. SieswerdaHoogendoorn T., van Rijn R.R. Current tech
niques in postmortem imaging with specific attention to
pediatric application. Pediatr. Radiol. 2010; 40: 141–152.
16. Rutty G.N., Robinson C.E., BouHaidar R. et al. The role of
mobile computed tomography in mass fatality incidents.
J. Forensic. Sci. 2007; 52: 1343–1349.
17. Scholing M., Saltzherr T.P., Fung Kon Jin P.H.P. et al. The
value of postmortem computed tomography as an alter
native for autopsy in trauma victims: a systematic review.
Eur. Radiol. 2009; 19: 2333–2341.
18. Levy G., Goldstein L., Blachar A. et al. Postmortem com
puted tomography in victims of military air mishaps: radio
logicalpathological correlation of CT findings. Isr. Med.
Assoc. J. 2007; 9: 699–702.
19. Yen K., Lovblad K.O., Scheurer E. et al. Postmortem forensic neuroimaging: correlation of MSCT and MRI findings
with autopsy results. Forensic. Sci. Int. 2007; 173: 21–35.
20. Халиков А.Д., Александрова З.Д., Трофимова Т.Н. и др.
Виртуальная аутопсия мертворожденного с пентадой
кантрелла и частичной формой спондилоторакально
го дизостоза. Журн. акуш. и жен. бол. 2009; 1: 50–55.
21. Cha J.G., Kim D.H., Kim D.H. et al. Utility of Postmortem
Autopsy via WholeBody Imaging: Initial Observations
Comparing MDCT and 3.0T MRI Findings with Autopsy
Findings. Korean. J. Radiol. 2010; 11 № 4: 395–406.
22. Bolliger S.A., Thali M.J., Ross S. et al. Virtual autopsy
using imaging: bridging radiologic and forensic sciences.
A review of the Virtopsy and similar projects. Eur. Radiol.
2008; 18: 273–282.
23. Durlacher S.H., Banfield W.G. Jr., Bergner A.D. Post
mortem pulmonary edema. Yale J. Biol. Med. 1950; 22:
565–572.
24. Rutty G.N. Postmortem changes and artefacts. In: Rutty
G.N. (Ed.). Essentials of autopsy practice. London:
Springer, 2001; 1: 63–96.
25. Tsokos M. Postmortem changes and artifacts occurring
during the early postmortem interval. In: Tsokos M. (Ed.).
Forensic Pathology Reviews. Humana Press, Totowa, New
Jersey, 2005; 3: 183–237.
26. Jackowski C., Thali M., Aghayev E. et al. Postmortem
imaging of blood and its characteristics using MSCT and
MRI. Int. J. Legal. Med. 2006; 120: 233–240.
27. Jackowski C., Sonnenschein M., Thali M.J. et al. Virtopsy:
postmortem minimally invasive angiography using cross
section techniques – implementation and preliminary
results. J. Forensic. Sci. 2005; 50: 1175–1186.
28. Grabherr S., Djonov V., Friess A. et al. Postmortem
angiography after vascular perfusion with diesel oil and a
lipophilic contrast agent. Am. J. Roentgenol. 2006; 187:
W515–W523.
29. Thali M.J., Yen K., Schweitzer W. et al. Into the decomposed
body: forensic digital autopsy using multislicecomputed
tomography. Forensic. Sci. Int. 2003; 134: 109–114.
30. Cassart M., Massez A., Cos T. et al. Contribution of 3D com
puted tomography in the assessment of fetal skeletal dysplasia. Ultrasound. Obstet. Gynecol. 2007; 29: 537–543.
31. Ferran J.L. Scanner 2 et 3D et squelette foetal: utile ou
nocif? Etude preliminaire. Couture A. Les malformations
congenitales. Montpellier: Sauramps medical, 2003; 2:
247–257.
32. Ruano R., Molho M., Roume J., Ville Y. Prenatal diagnosis
of fetal skeletal dysplasias by combining two-dimensional
and threedimensional ultrasound and intrauterine 3D
helical computer tomography. Ultrasound. Obstet.
Gynecol. 2004; 24: 134–140.
33. MacØG., Sonigo P., CormierDaire V. et al. Three-dimensional helical computed tomography in prenatal diagnosis
of fetal skeletal dysplasia. Ultrasound Obstet. Gynecol.
2013; 42: 161–168.

Postmortem Computed Tomography of Stillborn with Bone Pathology

Presents the data of the literature and our own observations of application of spiral computed tomography (SCT) to analyze the bodies of stillborn. The positive aspects and difficulties in conducting postmortem SKT. Presented observations of miscarriage and fetal death from congenital anomalies of the skeletal system. The high efficiency of post mortem CT bodies of stillborn, allowing an objective and accurate analysis of bone pathology, including through the creation of 3D reconstruction. The conclusion about the feasibility of in certain cases posthumous SKT as a supple ment to autopsy and forensic medical research.

Keywords:
postmortem computed tomography, stillborn, stillbirth.