PMCT-based verification of the validity of performing the classic cardiac air embolism test as the initial procedure in forensic autopsy

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Forensic Imaging Pub Date : 2026-05-01 Epub Date: 2026-05-14 DOI:10.1016/j.fri.2026.200708

Artur Moskala, Krzysztof Wozniak

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引用次数: 0

Abstract

Introduction

Cardiac air embolism is a challenging pathology to verify in the field of forensic medicine. The conventional evaluation method for cardiac air embolism entails incising the pericardial sac, filling it with water, and puncturing the right and left ventricles to ascertain the presence of gas bubbles, indicative of a positive test result. It is recommended that this test be performed as the initial step in an autopsy, prior to the opening of the cranial cavity, due to a risk of artefacts. Nevertheless, the veracity of this assumption remains unproven.

The employment of post-mortem computed tomography (PMCT) has facilitated the evaluation of gas spaces in corpses, rendering the process relatively straightforward and unambiguous. Consequently, it has become feasible to objectively verify whether opening the cranial cavity effectively hinders the performance of a reliable, classic test for cardiac air embolism.

The material and method: The study was conducted using a Siemens Somatom Go 16 CT scanner. Cases of non-traumatic death were examined using PMCT both before (head and trunk protocols) and after opening the cranial cavity (trunk protocol). Cases in which the initial PMCT examination revealed the presence of gas in the circulatory system were excluded from the study. The evaluation of the acquisition results was conducted in lung window using the RadiAnt software. The extent to which air entered the vascular system after opening the cranial cavity in the neck and thorax blood vessels was assessed.

Results and Conclusions

In a number of the cases that were examined, air displacement into the vascular system in the neck and heart was observed. This finding serves to substantiate the hypothesis that a conventional diagnostic procedure for cardiac air embolism should be conducted prior to opening the cranial cavity.

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基于pmct的经典心脏空气栓塞试验作为法医尸检初始程序的有效性验证

在法医学领域，心脏空气栓塞是一种具有挑战性的病理。心脏空气栓塞的常规评估方法是切开心包囊，充入水，穿刺左右心室以确定气泡的存在，表明检测结果为阳性。由于存在人工制品的风险，建议将该测试作为尸检的第一步，在打开颅腔之前进行。然而，这一假设的真实性尚未得到证实。使用尸体计算机断层扫描（PMCT）有助于评估尸体中的气体空间，使这个过程相对简单和明确。因此，客观地验证打开颅腔是否有效地阻碍了可靠的、经典的心脏空气栓塞测试的性能已经成为可能。材料和方法：本研究使用西门子Somatom Go 16 CT扫描仪进行。非创伤性死亡病例在开颅前（头部和躯干方案）和开颅后（躯干方案）使用PMCT进行检查。最初的PMCT检查显示循环系统中存在气体的病例被排除在研究之外。使用RadiAnt软件在肺窗中对采集结果进行评估。在打开颈部和胸腔血管的颅腔后，评估空气进入血管系统的程度。在法医学领域，心脏空气栓塞是一个具有挑战性的病理验证。心脏空气栓塞的常规评估方法是切开心包囊，充入水，穿刺左右心室以确定气泡的存在，表明检测结果为阳性。由于存在人工制品的风险，建议将该测试作为尸检的第一步，在打开颅腔之前进行。然而，这一假设的真实性尚未得到证实。使用尸体计算机断层扫描（PMCT）有助于评估尸体中的气体空间，使这个过程相对简单和明确。因此，客观地验证打开颅腔是否有效地阻碍了可靠的、经典的心脏空气栓塞测试的性能已经成为可能。材料和方法：本研究使用西门子Somatom Go 16 CT扫描仪进行。非创伤性死亡病例在开颅前（头部和躯干方案）和开颅后（躯干方案）使用PMCT进行检查。最初的PMCT检查显示循环系统中存在气体的病例被排除在研究之外。使用RadiAnt软件在肺窗中对采集结果进行评估。在打开颈部和胸腔血管的颅腔后，评估空气进入血管系统的程度。结果与结论在本研究的一些病例中，观察到颈部和心脏血管系统的空气置换。这一发现证实了一个假设，即心脏空气栓塞的常规诊断程序应该在打开颅腔之前进行。在一些被检查的病例中，观察到空气置换进入颈部和心脏的血管系统。这一发现证实了一个假设，即心脏空气栓塞的常规诊断程序应该在打开颅腔之前进行。

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

Forensic Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.20

自引率

27.30%

发文量