利用死后计算机断层扫描上的高密度边缘标志识别枪弹射入伤。

IF 2.2 3区 医学 Q1 MEDICINE, LEGAL
Emilien Jupin-Delevaux, Corentin Provost, Ghazi Hmeydia, Marie-Edith Richard, Lilia Hamza, Tania Delabarde, Marie Crahès, Validire Pierre, Bertrand Ludes, Catherine Oppenheim, Joseph Benzakoun
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引用次数: 0

摘要

死后计算机断层扫描(PMCT)是法医学中越来越常用的一种评估头部枪伤的工具。穹隆斜面征(如果存在)可提供有关入口和出口伤口的信息;如果不存在,在 PMCT 上识别伤口类型仍然具有挑战性。Junno 等人(2022 年)在一项动物研究中描述的皮肤高密度环可能是接触性枪击的标志。我们假设在人类枪伤中也能观察到这种现象。我们的研究评估了在 PMCT 中用皮肤高密度边缘征识别入口枪伤的可靠性。在排除复杂伤口和粘膜伤口后,两名操作员对 34 例头部 PMCT(2018-2022 年)中的 64 处枪伤(30 处入口伤口和 34 处出口伤口)进行了回顾性评估。确定伤口类型的金标准是尸检报告。高密度边缘征的定义是,在与伤口相切的皮肤组织多平面重建图上,至少有三分之二的连续皮肤高密度圆。高密度边缘征在识别入口伤口方面的特异性为 97%(95% CI:85%-100%),灵敏度为 63%(95% CI:44%-80%)。此外,在 16 份外部检查报告中,明确提到入口伤口处存在火药残留物或子弹擦拭物,观察到高密度边缘征与这些元素的存在呈正相关(p = 0.018)。这些研究结果表明,高密度边缘征(如果存在)与其他 CT 和尸检特征相结合,可能是确定枪伤入口伤口的重要工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identification of gunshot entry wounds using hyperdense rim sign on post-mortem computed tomography.

Post-mortem computed tomography (PMCT) is an increasingly utilized tool in forensic medicine for evaluating head gunshot injuries. Vault bevelling sign, when present, provides information regarding entry and exit wounds; when absent, identifying wound type on PMCT remains challenging. A cutaneous hyperdense ring, described in an animal study by Junno et al. (2022), may be indicative of contact shots. We hypothesized that it could also be observed in human gunshot injuries. Our study evaluates the reliability of the cutaneous hyperdense rim sign for identifying entry gunshot wounds in PMCT. After excluding complex and mucosal wounds, two operators retrospectively evaluated 64 gunshot wounds (30 entry and 34 exit wounds) in 34 head PMCT cases (2018-2022). Gold standard for wound type determination was the autopsy report. The hyperdense rim sign was defined as at least two-thirds of a continuous cutaneous hyperdense circle on a multiplanar reconstruction of cutaneous tissue tangent to the wound. The hyperdense rim sign demonstrated a specificity of 97% (95% CI: 85-100%) and a sensitivity of 63% (95% CI: 44-80%) for identifying entry wounds. Moreover, in 16 external examination reports where the presence of powder residues or bullet wipe at entry wound was explicitly mentioned, a positive association was observed between hyperdense rim sign and the presence of these elements (p = 0.018). These findings suggest that the hyperdense rim sign, when present, may be a valuable tool for entry wound determination in gunshot injuries, interpreted in conjunction with other CT and autopsy features.

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来源期刊
CiteScore
5.80
自引率
9.50%
发文量
165
审稿时长
1 months
期刊介绍: The International Journal of Legal Medicine aims to improve the scientific resources used in the elucidation of crime and related forensic applications at a high level of evidential proof. The journal offers review articles tracing development in specific areas, with up-to-date analysis; original articles discussing significant recent research results; case reports describing interesting and exceptional examples; population data; letters to the editors; and technical notes, which appear in a section originally created for rapid publication of data in the dynamic field of DNA analysis.
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