Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum94600ArticlesСтатьиReview ArticleActual possibilities of postmortem imaging in forensic medicine practiceРеальные возможности посмертной лучевой диагностики в практике судебно-медицинского экспертаKovalevA. VКовалевА. В

д-р мед. наук, дир. ФГБУ РЦСМЭ, гл. внештатный специалист по судебно-медицинской экспертизе Минздрава России

mail@rc-sme.ruKinleA. FКинлеА. Ф

канд. мед. наук, проф., зав. каф. судебной медицины ФГБОУ ДПО РМАНПО

kinle-alexandr@mail.ruKokovL. SКоковЛ. С

чл.-кор. РАН, проф., рук. отд-ния рентгенохирургических методов диагностики и лечения ГБУЗ НИИ СП им. Н.В.Склифосовского, зав. каф. лучевой диагностики ИПО ФГБОУ ВО Первый МГМУ им И.М.Сеченова

lskokov@mail.ruSinitsynV. AСиницынВ. А

д-р мед. наук, проф., рук. Центра лучевой диагностики ФГАУ ЛРЦ, рук. курса лучевой диагностики ФФМ ФГБОУ ВО МГУ им М.В.Ломоносова

vsini@mail.ruFetisovV. AФетисовВ. А

д-р мед. наук, зав. научно-организационным отд. ФГБУ РЦСМЭ

FilimonovB. AФилимоновБ. А

канд. мед. наук, сотр. каф. судебной медицины ФГБОУ ДПО РМАНПО, глав. ред. журнала «Consilium Medicum»

filimonov@hpmp.ruRussian Center of Judicial Medical Expertise of the Ministry of Health of the Russian FederationФГБУ Российский центр судебно-медицинской экспертизы Минздрава РоссииRussian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian FederationФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования Минздрава РоссииN.V.Sklifosovsky Research Institute of Emergency Medicine of the Department of Health of MoscowГБУЗ НИИ скорой помощи им. Н.В.Склифосовского Департамента здравоохранения г. МосквыI.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian FederationФГБОУ ВО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава РоссииTreatment and Rehabilitation Center of the Ministry of Health of the Russian FederationФГАУ Лечебно-реабилитационный центр Минздрава РоссииM.V.Lomonosov Moscow State UniversityФГБОУ ВПО Московский государственный университет им. М.В.Ломоносова201220161813VOL 18, NO13 (2016)ТОМ 18, №13 (2016)92528122021Copyright ©; 2016, Consilium MedicumCopyright ©; 2016, ООО "Консилиум Медикум"2016Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/94600

Purpose of the study. The review analyzed the results of studies on the use of computed tomography (CT) and magnetic resonance imaging (MRI) in a forensic expertise (FE) of the adults. The purpose of this review is to introduce forensic radiologists and situations, the most common in postmortem imaging, as well as its strengths and weaknesses. Material and methods. The basic Internet resources used: Russian Scientific Electronic Library (elibrary.ru), Embase, Medline, Web of Science, Cochrane database. Results and conclusions. Methods for FE postmortem imaging are under active study and formation of the evidence base. "The gold standard" postmortem diagnosis is a traditional autopsy. But the role of tomographic methods of research is growing. For practical purposes, the FE adult cadavers more suitable for CT. In some cases, autopsy should be combined with different methods of beam diagnostics - CT, CT angiography and MRI. Posthumous ray diagnosis can be of great help in the visualization of mechanical damage, as well as to determine the cause in some cases, sudden death. Posthumous imaging may be required in some other common situations in the practice of FE: mechanical asphyxia, drowning, action of high and low temperature, research rotten modified and unidentified bodies, detection of foreign bodies.

Цель исследования. В обзоре проанализированы результаты исследований по проблеме использования компьютерной томографии (КТ) и магнитно-резонансной томографии (МРТ) в судебно-медицинской экспертизе (СМЭ) взрослых лиц. Целью настоящего обзора является ознакомление судебно-медицинских экспертов и рентгенологов с ситуациями, наиболее распространенными в посмертной визуализации, а также с ее сильными и слабыми сторонами. Материал и методы. Использованы основные интернет-ресурсы: Российская научная электронная библиотека (elibrary.ru), Embase, Medline, Web of Science, Cochrane database. Результаты и выводы. Методы посмертной визуализации в СМЭ находятся на стадии активного изучения и формирования доказательной базы. «Золотым стандартом» посмертной диагностики остается традиционная аутопсия. Но роль томографических методов исследования постоянно растет. Для практических целей СМЭ трупов взрослых в большей степени подходит КТ. В ряде случаев следует комбинировать с аутопсией разные лучевые методы диагностики - КТ, КТ-ангиографию и МРТ. Посмертная лучевая диагностика может оказать большую помощь в визуализации механических повреждений, а также в установлении причины в ряде случаев скоропостижной смерти. Посмертная визуализация может быть востребована и в некоторых других распространенных в практике СМЭ ситуациях: механической асфиксии, утоплении, действии высокой и низкой температуры, исследовании гнилостно измененных и неопознанных трупов, выявлении инородных тел.

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