计算机断层扫描引导下的死后活检评估肺炎的价值

IF 2.5 3区医学 Q1 MEDICINE, LEGAL

Forensic science international Pub Date : 2025-08-18 DOI:10.1016/j.forsciint.2025.112612

Tomoaki Hagita , Akiko Takeuchi , Shogo Shimbashi , Hideki Hyodoh , Kotaro Matoba , Tomoko Matoba , Takayuki Kiuchi , Shigeki Jin

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引用次数: 0

摘要

目的探讨利用计算机断层扫描（CT）引导下的死后肺活检诊断肺炎的可行性，并将死后CT （PMCT）和血液分析结果与组织病理学结果进行比较。方法选取13例3 d内死亡，经组织病理学检查证实有中性粒细胞浸润的患者。所有患者在尸检前都进行了PMCT，随后在疑似肺炎的区域进行了ct引导的尸检活检。在尸检开始时从心脏采集血液样本，并测量c反应蛋白（CRP）和前压蛋白酶（P-SEP）水平。结果spmct检出肺实质增生5例（38.5 %）。双侧异常6例（46.2% %），单侧异常7例（53.8% %）。弥漫性分布7例（53.8% %），局限性分布6例（46.2% %）。外观表现（有重叠）包括网状4例（30.8 %），毛玻璃样混浊2例（15.4 %），斑片状10例（76.9 %），结节性聚积3例（23.1 %）（23.1 %）。由于高粘度，CRP和P-SEP不能分别在一个病例中测量。12例患者CRP水平均超过正常范围，P-SEP水平正常2例（16.7 %）。结论：本研究强调了仅使用PMCT和血液检查诊断肺炎的局限性。然而，ct引导下的死后活检有助于肺炎的识别，即使PMCT和血液检查无法检测到炎症。

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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Usefulness of computed tomography-guided postmortem biopsy to evaluate pneumonia

Purpose

This study examined the feasibility of utilizing computed tomography (CT)-guided postmortem lung biopsy to diagnose pneumonia and compared the findings from postmortem CT (PMCT) and blood analyses with histopathological results.

Methods

The study included 13 patients who had died within 3 days and had confirmed neutrophil infiltration through histopathological examination. All patients underwent PMCT before autopsy, followed by CT-guided postmortem biopsy on the areas with suspected pneumonia. Blood samples were collected from the heart at the start of autopsy, and C-reactive protein (CRP) and presepsin (P-SEP) levels were measured.

Results

PMCT revealed pulmonary hypostasis in five cases (38.5 %). Abnormal appearances were observed bilaterally in six cases (46.2 %) and unilaterally in seven cases (53.8 %). The distribution was diffuse in seven cases (53.8 %) and localized in six cases (46.2 %). The appearance findings (with overlap) included reticular in four cases (30.8 %), ground-glass opacities in two cases (15.4 %), patchy in 10 cases (76.9 %), and three cases (23.1 %) had nodular collections (23.1 %). CRP and P-SEP could not be measured in one case each, due to high viscosity. Of the 12 cases, all CRP levels exceeded the normal range, while P-SEP levels were normal in two cases (16.7 %).

Conclusion

This study highlights limitations in diagnosing pneumonia solely using PMCT and blood tests. However, CT-guided postmortem biopsy facilitates the identification of pneumonia even when inflammatory findings are not detectable by PMCT and blood tests.

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来源期刊

Forensic science international 医学-医学：法

CiteScore

5.00

自引率

9.10%

发文量

285

审稿时长

49 days

期刊介绍： Forensic Science International is the flagship journal in the prestigious Forensic Science International family, publishing the most innovative, cutting-edge, and influential contributions across the forensic sciences. Fields include: forensic pathology and histochemistry, chemistry, biochemistry and toxicology, biology, serology, odontology, psychiatry, anthropology, digital forensics, the physical sciences, firearms, and document examination, as well as investigations of value to public health in its broadest sense, and the important marginal area where science and medicine interact with the law. The journal publishes: Case Reports Commentaries Letters to the Editor Original Research Papers (Regular Papers) Rapid Communications Review Articles Technical Notes.