Study On CT Diagnosis Of Drowned Corpse

Objective:By comparing and analyzing the different CT imaging features of the drowned bodies and non-drowned bodies,the paper provides forensic evidence for the CT imaging diagnosis of the drowned bodies.Methods:A total of 50 drowned bodies and 50 non-drowned bodies were collected from January 2020 to January 2021 in Beijing.After SOMATOM Perspective 128 CT scan with anythink CT plus 3 d image post-processing analysis,respectively to observe the head CT in maxillary sinus,frontal sinus,sphenoid sinus and mastoid air cells presence of effusion,and chest CT films with and without tracheal or bronchial fluid and lung parting,measuring atrial indoor and the density of the fluid,abdominal computed tomography(CT)in the stomach and duodenum liquid,and the density of the spleen.Excel and SPSS were used for statistical analysis.Results:The positive rates of effusion in maxillary sinus,sphenoid sinus,frontal sinus and mastoid air chamber in drowned bodies were 98%,88%,72% and 10%,respectively,while those in non-drowned bodies were 14%,4%,2% and 0%.The effusion in maxillary sinus,frontal sinus and sphenoid sinus was P < 0.05,and the difference was statistically significant.The positive rates of tracheal effusion and bronchial effusion were 76% and 86%respectively.Not drown bodies tracheal and bronchial fluid positive rate were 2%,12%,the 2 test or fisher’s exact test,P < 0.05,the difference is statistically significant.The pulmonary manifestations of drowning cadavers were as follows: 23 cases showed an indistinct centrilobular nodules and patchy ground glass opacity diffusing along the airway,and 20 cases showed two diffuse ground glass opacity with acinus and interlobular stroma thickening.There were 3 cases of consolidation,emphysema or fibrosis in 6 cases and 4 cases of inseparability in 1 case.The corresponding pulmonary manifestations of non-drowning caddies were 43,4,3,and 0,respectively.Among them,two diffuse ground glass opacities with thickening of acinus and interlobular stroma were more characteristic than those of non-drowned bodies.The mean CT values of the fluid in the left atrium,right atrium,left ventricle and right ventricle of the drowned cadavers were 53.95±11.98HU(24.5HU～79HU),54.37±12.43HU(22.10HU～77.00HU),44.70±10.34HU(22.10HU～68.00HU),50.10±9.98HU(29.40HU～69HU),respectively.The mean CT values of the fluid in the heart cavities of the left atrium,right atrium,left ventricle and right ventricle of the non-drowning cadavers were53.08±7.77HU(35HU～72HU),50.16±5.85HU(29HU～63HU),40.36±6.58HU(27HU～56HU),and 43.98±7.21HU(25HU～61HU).By two independent samples t test,there was no significant difference in the mean CT value of left atrium blood between drowned and non-drowned corpses.The mean CT value of left ventricle,right atrium and right ventricle blood of drowned corpses was higher than that of non-drowned corpses.The positive rate of gastric stratification was 52%,which was higher than that of2% in non-drowning corpses.Duodenal fluid level was seen in 42 drowned corpses and36 non-drowned corpses(P = 0.148,P > 0.05).The mean CT value of spleen density was 41.01 ± 10.17 HU(13.80HU～62.00HU)。 The average CT value of spleen density in non-drowning corpses was 42.76±8.49HU(25.00 HU ～ 67.00HU),P = 0.353,P > 0.05,there was no significant difference between them.Conclusion:There were significant differences in maxillary sinus,frontal sinus,sphenoid sinus effusion,trachea and bronchus effusion between drowned and non-drowned corpses(P< 0.05).The lung CT findings of drowned corpses were diffuse ground glass opacity with thickening of acini and interlobular septum,which can be used to assist in the diagnosis of drowning.Combined with other imaging findings,gastric stratification can be used to support drowning.The comprehensive application of these signs will provide a basis for forensic workers to determine drowning.