Selective postmortem arterial angiography of head and neck using digital x-ray or computed tomography: A practical and rapid method to identify vascular injuries

IF 1.5 4区 医学 Q2 MEDICINE, LEGAL
Zabiullah Ali MD, Nikki Mourtzinos DO, MHS
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引用次数: 0

Abstract

Identification of vascular injuries is crucial for complete postmortem evaluation and understanding of trauma deaths by the Medical Examiner. Some vascular injuries are difficult to evaluate due to challenging anatomic locations, especially in the head and neck. Documenting injuries of the facial and vertebral arteries is challenging and necessitates time-consuming dissections that can create artifacts and disfigurement. In busy medical examiner offices with a significant number of traumatic injuries, finding a creative solution to employ reliable postmortem angiography is desirable. At the Office of the Chief Medical Examiner for the State of Maryland (OCME), we created and effectively implemented a selective angiography procedure using traditional indwelling Foley catheters and water-soluble barium swallow contrast to evaluate arterial injuries using either digital radiography or computed tomography imaging modalities. This technique and imaging interpretation can be performed by a medical examiner or forensic pathology fellow after basic technical training and basic radiology training. This study outlines the technique, methods, and utilization of the procedure and describes the findings of six deaths due to vascular lesions from different injury mechanisms and disease processes and describes the ease of implementation on a broader scale in busy Medical Examiner's offices.

使用数字 X 光或计算机断层扫描对头颈部进行选择性死后动脉造影:识别血管损伤的实用快速方法。
血管损伤的鉴定对于法医对创伤死亡进行完整的尸检评估和理解至关重要。由于解剖位置具有挑战性,有些血管损伤很难评估,尤其是在头部和颈部。记录面部和椎动脉的损伤具有挑战性,必须进行耗时的解剖,否则会造成假象和毁容。繁忙的法医办公室需要处理大量的外伤,因此需要找到一种创造性的解决方案来采用可靠的死后血管造影术。在马里兰州首席法医办公室(OCME),我们创建并有效实施了一种选择性血管造影程序,使用传统的留置 Foley 导管和水溶性吞钡造影剂,利用数字射线或计算机断层扫描成像模式评估动脉损伤。经过基本技术培训和基本放射学培训后,法医或法医病理学研究员即可进行这项技术和成像解读。本研究概述了该程序的技术、方法和使用情况,描述了六例因不同损伤机制和疾病过程导致的血管病变而死亡的调查结果,并说明了在繁忙的法医办公室更广泛地实施该程序的难易程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of forensic sciences
Journal of forensic sciences 医学-医学:法
CiteScore
4.00
自引率
12.50%
发文量
215
审稿时长
2 months
期刊介绍: The Journal of Forensic Sciences (JFS) is the official publication of the American Academy of Forensic Sciences (AAFS). It is devoted to the publication of original investigations, observations, scholarly inquiries and reviews in various branches of the forensic sciences. These include anthropology, criminalistics, digital and multimedia sciences, engineering and applied sciences, pathology/biology, psychiatry and behavioral science, jurisprudence, odontology, questioned documents, and toxicology. Similar submissions dealing with forensic aspects of other sciences and the social sciences are also accepted, as are submissions dealing with scientifically sound emerging science disciplines. The content and/or views expressed in the JFS are not necessarily those of the AAFS, the JFS Editorial Board, the organizations with which authors are affiliated, or the publisher of JFS. All manuscript submissions are double-blind peer-reviewed.
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