{"title":"死后冠状动脉病理学成像:利用死后红外冠状动脉造影术对人体心脏进行原位法医心脏成像","authors":"Y.G. Kolev , P.G.Y. Kolev , N.M. Mirochnik","doi":"10.1016/j.fri.2024.200584","DOIUrl":null,"url":null,"abstract":"<div><p>The diagnostic assessment of sudden and unexpected cardiovascular deaths remains intricate in forensic medicine. Building upon the foundational technique introduced by P. Fais et al.(2018), we present modifications to the post-mortem infrared coronary angiography (PIC) tailored specifically for the assessment of human hearts. Refinements to PIC encompass the integration of a 3D-printed clamp for catheter stabilization and the procedural alteration of utilizing warm water injections, negating the need for additional cardiac cooling. An enhanced imaging modality is achieved using the FLIR Thermal Lepton 3.5 camera, embedded within the robust Cat S62 Pro mobile device, ensuring optimal resolution and suitability for an autopsy environment. The advanced PIC technique provides superior visualization of the coronary arteries, frequently correlating with subsequent autopsy and histological assessments. Notably, the method allows immediate continuation to the autopsy without compromising the cardiac structure. Nevertheless, certain anatomical variances, such as muscular bridging or pronounced pericardial fat, might reduce locally what appears to be an otherwise excellent specificity. The refined PIC method emerges as a pivotal diagnostic adjunct in forensic evaluations of sudden cardiovascular fatalities. Its ability to preserve cardiac integrity and facilitate uninterrupted autopsy progression underscores its potential utility. However, rigorous validation is imperative to ascertain its comprehensive applicability and inherent limitations.</p></div>","PeriodicalId":40763,"journal":{"name":"Forensic Imaging","volume":"36 ","pages":"Article 200584"},"PeriodicalIF":0.8000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666225624000083/pdfft?md5=bb23679d74c2bc84629a6345af269392&pid=1-s2.0-S2666225624000083-main.pdf","citationCount":"0","resultStr":"{\"title\":\"PICturing coronary pathology postmortem: forensic cardiac imaging with Postmortem Infrared Coronary angiography of human heart ex situ\",\"authors\":\"Y.G. Kolev , P.G.Y. Kolev , N.M. Mirochnik\",\"doi\":\"10.1016/j.fri.2024.200584\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>The diagnostic assessment of sudden and unexpected cardiovascular deaths remains intricate in forensic medicine. Building upon the foundational technique introduced by P. Fais et al.(2018), we present modifications to the post-mortem infrared coronary angiography (PIC) tailored specifically for the assessment of human hearts. Refinements to PIC encompass the integration of a 3D-printed clamp for catheter stabilization and the procedural alteration of utilizing warm water injections, negating the need for additional cardiac cooling. An enhanced imaging modality is achieved using the FLIR Thermal Lepton 3.5 camera, embedded within the robust Cat S62 Pro mobile device, ensuring optimal resolution and suitability for an autopsy environment. The advanced PIC technique provides superior visualization of the coronary arteries, frequently correlating with subsequent autopsy and histological assessments. Notably, the method allows immediate continuation to the autopsy without compromising the cardiac structure. Nevertheless, certain anatomical variances, such as muscular bridging or pronounced pericardial fat, might reduce locally what appears to be an otherwise excellent specificity. The refined PIC method emerges as a pivotal diagnostic adjunct in forensic evaluations of sudden cardiovascular fatalities. Its ability to preserve cardiac integrity and facilitate uninterrupted autopsy progression underscores its potential utility. However, rigorous validation is imperative to ascertain its comprehensive applicability and inherent limitations.</p></div>\",\"PeriodicalId\":40763,\"journal\":{\"name\":\"Forensic Imaging\",\"volume\":\"36 \",\"pages\":\"Article 200584\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666225624000083/pdfft?md5=bb23679d74c2bc84629a6345af269392&pid=1-s2.0-S2666225624000083-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Forensic Imaging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666225624000083\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Forensic Imaging","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666225624000083","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
在法医学中,对心血管意外猝死的诊断评估仍然错综复杂。在 P. Fais 等人(2018 年)介绍的基础技术的基础上,我们介绍了专为评估人类心脏而定制的死后红外冠状动脉造影术(PIC)的改进。对红外冠状动脉造影的改进包括整合了用于稳定导管的 3D 打印夹钳,以及利用温水注射的程序改变,从而无需额外的心脏冷却。使用嵌入在坚固耐用的 Cat S62 Pro 移动设备中的 FLIR Thermal Lepton 3.5 相机实现了增强的成像模式,确保了最佳分辨率和尸检环境的适用性。先进的 PIC 技术可提供卓越的冠状动脉可视化,经常与后续的尸检和组织学评估相关联。值得注意的是,该方法可在不影响心脏结构的情况下立即继续进行尸检。然而,某些解剖结构上的差异,如肌肉桥接或明显的心包脂肪,可能会在局部降低看似极佳的特异性。改良的 PIC 方法在心血管猝死的法医评估中成为一种重要的辅助诊断方法。该方法能够保持心脏的完整性,并促进尸检的不间断进行,这凸显了其潜在的实用性。然而,要确定其全面适用性和固有局限性,严格的验证势在必行。
PICturing coronary pathology postmortem: forensic cardiac imaging with Postmortem Infrared Coronary angiography of human heart ex situ
The diagnostic assessment of sudden and unexpected cardiovascular deaths remains intricate in forensic medicine. Building upon the foundational technique introduced by P. Fais et al.(2018), we present modifications to the post-mortem infrared coronary angiography (PIC) tailored specifically for the assessment of human hearts. Refinements to PIC encompass the integration of a 3D-printed clamp for catheter stabilization and the procedural alteration of utilizing warm water injections, negating the need for additional cardiac cooling. An enhanced imaging modality is achieved using the FLIR Thermal Lepton 3.5 camera, embedded within the robust Cat S62 Pro mobile device, ensuring optimal resolution and suitability for an autopsy environment. The advanced PIC technique provides superior visualization of the coronary arteries, frequently correlating with subsequent autopsy and histological assessments. Notably, the method allows immediate continuation to the autopsy without compromising the cardiac structure. Nevertheless, certain anatomical variances, such as muscular bridging or pronounced pericardial fat, might reduce locally what appears to be an otherwise excellent specificity. The refined PIC method emerges as a pivotal diagnostic adjunct in forensic evaluations of sudden cardiovascular fatalities. Its ability to preserve cardiac integrity and facilitate uninterrupted autopsy progression underscores its potential utility. However, rigorous validation is imperative to ascertain its comprehensive applicability and inherent limitations.