RESUMENLos modernos métodos de imagen, como la CT y la RNM proporcionan datos reales y tridimensionales de la superficie y las estructuras internas corporales. Esta información se almacena en ficheros DICOM (un protocolo estándar en adquisición de imagen radiológica). Sobre esos ficheros pueden realizarse muchos procedimientos de análisis de imagen, tales como visualización interactiva, morfometría, reconstrucciones tridimensionales, etc. Estas tareas son realizadas de una manera no invasiva y no destructiva, pudiéndose almacenar los resultados para documentación del caso. El presente trabajo describe las bases de los procedimientos de análisis de imagen sobre ficheros DICOM dirigidos a propósitos forenses (la llamada "virtopsia"), enfatizando la utilidad del método en Patología, Traumatología Forense y otros campos.La "virtopsia" debe ser considerada no sólo como un procedimientos post-mortem (complementando pero no sustituyendo a la autopsia tradicional), sino como un modo de examinar partes corporales de una manera interactiva, sea en el fallecido o en el sujeto vivo. Ello amplia su utilidad y hace apropiado el procedimiento siempre que se requiera un examen anatómico forense reproducible, preciso, interactivo y en tiempo real.Palabras clave: Análisis de imagen, Proceso de imagen, ficheros DICOM, Radiología digital, Autopsia, Virtopsia, Radiología cadavérica, Radiología asistida por ordenador. Cuad Med Forense 2005; 11(40):95-106 ABSTRACTModern imaging methods, such as radiological CT/MRI scanning provides real, full 3D data of the body surface and internal structures. This information is stored in DICOM files (a standard protocol in radiology image acquisition). Many image-analysis procedures, such as interactive visualization, morphometry, densitometry, three dimensional reconstruction, etc., can be carried-out on these files. These tasks are performed in a non-invasive and non-destructive manner, and the results can be stored in order to document the case.The present paper describes the basis of imageanalysis procedures on DICOM files directed to forensic purposes (socalled "virtopsy"), emphasizing the utility of the method in Pathology, Forensic Traumatology and other fields.The virtopsy must be considered not only as a postmortem procedure (complementing but not substituting the traditional autopsy), but a way to examine body parts in an interactive manner, whatever the subject is dead or alive. That spreads its utility and makes the method appropriate whenever an accurate, real-time, interactive and reproducible forensic anatomic examination is required.
Kyphoplasty could constitute an alternative and/or complementary treatment of traditional spinal stabilization-fusion procedures in non osteoporotic vertebral fractures. Therefore, it should be offered, when indicated, as a substantial possible part of the treatment, to the patients suffering from vertebral fractures. Additional advantages of combining kyphoplasty and posterior fusion are the possibility of reducing the number of fused levels (shorter instrumentations), and to perform a 360 degree stabilization-remodeling through a single posterior approach.
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