Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum94608ArticlesСтатьиReview ArticlePostmortem computed tomography and its features: what should clinical radiologists know?Что должен знать клинический рентгенолог об особенностях компьютерной томографии трупа?DubrovaS. EДуброваС. Э

канд. мед. наук, ассистент каф. лучевой диагностики фак-та усовершенствования врачей ГБУЗ МО МОНИКИ им. М.Ф.Владимирског

dubrovamoniki@rambler.ruFilimonovB. AФилимоновБ. А

канд. мед. наук, глав. ред. журнала «Consilium Medicum», ООО «Объединенная редакция»

filimonov@hpmp.ruM.F.Vladimirskiy Moscow Regional Research Clinical InstituteГБУЗ МО Московский областной научно-исследовательский клинический институт им. М.Ф.ВладимирскогоPublishing house “Ob’edinyonnaya redaktsia”ООО «Объединенная редакция»201220161813VOL 18, NO13 (2016)ТОМ 18, №13 (2016)384728122021Copyright ©; 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/94608

The data on postmortem CT in forensic-medical examination is analyzed in the current review, with the main reason of showing the clinical radiologists all the features of postmortem CT and main internet resources used in preparation of the review being: scientific electronic library (Elibrary), SciVerse (ScienceDirect), Scopus, PubMed and Discovery. The articles discussing the features of postmortem CT, important for those professionals who seldom face the postmortem visualisation in their daily work, are also included. The earlier and later postmortem changes, such as rigor mortis, autolysis, septic and other postmortem processes that change the normal perceptions in CT visualization significantly. While interpreting the postmortem CT images, radiologists should take into consideration the most frequent artefacts, taking place due to the postmortem blood clots in the heart cavities and big arteries, aspiration of the stomach contents into the airways, esophago - and gastromalacia, cadaveric hypostases in internal organs, violation of the differentiation between grey and white brain matter, putrid gases in the blood vessels, organs and tissues and many other features. Postmortem visualization requires the special training for radiologists in forensic medicine and has the features of the radial imagingintrinsic only for corpses. When lacking the special knowledge, even the most experienced and clinically competent radiologists can make serious diagnostic mistakes interpreting the postmortem CT images.

В обзоре проанализированы исследования по проблеме посмертной компьютерной томографии (КТ) в судебно-медицинской экспертизе трупа. Основная цель обзора - показать клиническим рентгенологам особенности КТ трупа. При подготовке обзора были использованы основные интернет-ресурсы: научная электронная библиотека (Elibrary), SciVerse (ScienceDirect), Scopus, PubMed и Discover. В обзор включены статьи, в которых обсуждались особенности посмертной КТ, важные для понимания проблемы клиническими рентгенологами, не сталкивающимися в своей повседневной деятельности с посмертной визуализацией. Ранние и поздние трупные изменения, такие как окоченение, аутолиз, гнилостные и другие посмертные процессы, в значительной степени меняют «норму» при КТ-визуализации. Рентгенологи при интерпретации КТ-изображений трупа должны учитывать наиболее часто встречающиеся артефакты, к которым приводят: посмертные свертки крови в полостях сердца и крупных сосудах, аспирация содержимого желудка в воздухоносные пути, эзофаго - и гастромаляция, трупные гипостазы во внутренних органах, нарушение дифференцировки между серым и белым веществом головного мозга, гнилостные газы в сосудах, органах и тканях и многие другие. Посмертная визуализация требует специальной подготовки рентгенологов по судебной медицине и имеет особенности лучевой картины, свойственные только трупу. При отсутствии специальных знаний даже очень опытные и грамотные клинические рентгенологи могут допустить серьезные диагностические ошибки при интерпретации посмертных КТ-изображений.

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