Abstract
Multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) are being increasingly implemented in forensic pathology. These methods may serve as an adjuvant to classic forensic autopsies. Imaging of the interior of corpses is performed using MSCT and/or MRI. MRI, in addition, is also well suited to the examination of surviving victims of assault, especially choking, and helps visualise internal injuries sometimes not seen on external examination of the victim. Various postprocessing techniques can provide strong forensic evidence for use in legal proceedings. The documentation and analysis of postmortem findings with MSCT and MRI and postprocessing techniques (virtopsy) is investigator independent, objective and noninvasive and will lead to qualitative improvements in forensic pathologic investigation. Apart from the accuracy and three dimensionality that conventional documentations lack, these techniques allow for the re-examination of the corpse and the crime scene even decades later, after burial of the corpse and liberation of the crime scene. We believe that this virtual, noninvasive or minimally invasive approach will improve forensic medicine in the near future.
Riassunto
La tomografia computerizzata multistrato (TCMS) e la risonanza magnetica (RM) sono metodiche d’imaging sempre più richieste in patologia forense. Tali tecniche possono essere di grande ausilio alle classiche autopsie medico-legali. La visualizzazione degli organi interni del cadavere può essere eseguita preventivamente utilizzando la TCMS e/o la RM. La RM, in aggiunta, è indicata anche per la valutazione delle vittime superstiti di azioni violente, in particolare lo strangolamento, in quanto aiuta ad individuare lesioni interne talvolta non apprezzabili neanche ad un’attenta osservazione esterna della vittima. Varie tecniche di post-elaborazione sono in grado di fornire indiscutibili prove legali da utilizzare nel corso dei vari procedimenti giudiziari. La documentazione e l’analisi dei reperti post-mortem individuati mediante TCMS e RM come pure alcune tecniche di post-elaborazione (virtopsy) sono esecutore-indipendenti, oggettive, non invasive e porteranno nel tempo a miglioramenti qualitativi nelle indagini patologiche forensi. A parte l’accuratezza e la tridimensionalità di cui mancano le documentazioni convenzionali, queste tecniche consentono di riesaminare sia il cadavere che il luogo del delitto anche decenni più tardi, dopo la sepoltura della salma e l’alterazione del luogo del reato. Noi crediamo che questo approccio virtuale, noninvasivo o minimamente invasivo permetterà di migliorare la medicina forense nel prossimo futuro. kw]
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References/Bibliografia
Randall BB, Fierro MF, Froede RC (1998) Practice guideline for forensic pathology. Members of the Forensic Pathology Committee, College of American Pathologists. Arch Pathol Lab Med 122:1056–1064
Di Maio VJ (1984) Basic principles in the investigation of homicides. Pathol Annu 19 Pt 2:149–164
Thali MJ, Jackowski C, Oesterhelweg L et al (2007) Virtopsy — the Swiss virtual autopsy approach. Leg Med 9:100–104
Thali MJ, Dirnhofer R, Becker R et al (2004) Is “virtual histology” the next step after the “virtual autopsy”? Magnetic resonance microscopy in forensic medicine. Magn Reson Imaging 22:1131–1138
Thali MJ, Schweitzer W, Yen K et al (2003) New horizons in forensic radiology: the 60-second digital autopsy-full-body examination of a gunshot victim by multislice computed tomography. Am J Forensic Med Pathol 24:22–27
Thali MJ, Yen K, Schweitzer W et al (2003) Into the decomposed body-forensic digital autopsy using multislice-computed tomography. Forensic Sci Int 134:109–114
Thali MJ, Yen K, Schweitzer W et al (2003) Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) — a feasibility study. J Forensic Sci 48:386–403
Dirnhofer R, Jackowski C, Vock P et al (2006) VIRTOPSY: minimally invasive, imaging-guided virtual autopsy. Radiographics 26:1305–1333
Donchin Y, Rivkind AI, Bar-Ziv J et al (1994) Utility of postmortem computed tomography in trauma victims. J Trauma 37:552–556
Ros PR, Li KC, Vo P et al (1990) Preautopsy magnetic resonance imaging: initial experience. Magn Reson Imaging 8:303–308
Thali MJ, Taubenreuther U, Karolczak M et al (2003) Forensic microradiology: micro-computed tomography (Micro-CT) and analysis of patterned injuries inside of bone. J Forensic Sci 48:1336–1342
Patriquin L, Kassarjian A, Barish M et al (2001) Postmortem whole-body magnetic resonance imaging as an adjunct to autopsy: preliminary clinical experience. J Magn Reson Imaging 13:277–287
Jackowski C, Sonnenschein M, Thali MJ et al (2005) Virtopsy: postmortem minimally invasive angiography using cross section techniquesimplementation and preliminary results. J Forensic Sci 50:1175–1186
Ross S, Spendlove D, Bolliger S et al (2008) Postmortem whole-body CT angiography: evaluation of two contrast media solutions. AJR Am J Roentgenol 190:1380–1389
Brüschweiler W, Braun M, Dirnhofer R, Thali MJ (2003) Analysis of patterned injuries and injury-causing instruments with forensic 3D/CAD supported photogrammetry (FPHG): an instruction manual for the documentation process. Forensic Sci Int 132:130–138
Thali MJ, Braun M, Markwalder TH et al (2003) Bite mark documentation and analysis: the forensic 3D/CAD supported photogrammetry approach. Forensic Sci Int 135:115–121
Thali MJ, Braun M, Wirth J et al (2003) 3D surface and body documentation in forensic medicine: 3- D/CAD Photogrammetry merged with 3D radiological scanning. J Forensic Sci 48:1356–1365
Ith M, Bigler P, Scheurer E et al (2002) Observation and identification of metabolites emerging during postmortem decomposition of brain tissue by means of in situ 1H-magnetic resonance spectroscopy. Magn Reson Med 48:915–920
Yen K, Vock P, Tiefenthaler B et al (2004) Virtopsy: forensic traumatology of the subcutaneous fatty tissue: multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) as diagnostic tools. J Forensic Sci 49:799–806
Pomara C, Karch SB, Mallegni F et al (2008) A medieval murder. Am J Forensic Med Pathol 29:72–74
Yen K, Thali M, Aghayev E et al (2005) Strangulation signs: initial correlation of MRI, MSCT and forensic neck findings. J Magn Reson Imaging 22:501–510
Ljung P, Winskog C, Persson A et al (2006) Full-body virtual autopsies using a state-of-the-art volume rendering pipeline. IEEE Trans Vis Comput Graph 12:869–876
Jackowski C, Aghayev E, Sonnenschein M et al (2006) Maximum intensity projection of cranial computed tomography data for dental identification. Int J Legal Med 120:165–167
Thali MJ, Markwalder T, Jackowski C et al (2006) Dental CT imaging as a screening tool for dental profiling: advantages and limitations. J Forensic Sci 51:113–119
Jackowski C, Lussi A, Classens M et al (2006) Extended CT scale overcomes restoration caused streak artifacts-3D color encoded automatic discrimination of dental restorations for identification. J Comput Assist Tomogr 30:510–513
Sidler M, Jackowski C, Dirnhofer R et al (2007) Use of multislice computed tomography in disaster victim identification: advantages and limitations. Forensic Sci Int 169:118–128
Hayakawa M, Yamamoto S, Motani H et al (2006) Does imaging technology overcome problems of conventional postmortem examination? A trial of computed tomography imaging for postmortem examination. Int J Legal Med 120:24–26
Magid D, Bryan BM, Drebin RA et al (1989) Three-dimensional imaging of an Egyptian mummy. Clin Imaging 13:239–240
Notman DN, Tashjian J, Aufderheide AC et al (1986) Modern imaging and endoscopic biopsy techniques in Egyptian mummies. AJR Am J Roentgenol 146:93–96
Cosmacini P, Piacentini P (2008) Notes on the history of the radiological study of Egyptian mummies: from X-rays to new imaging techniques. Radiol Med 113:615–626
World Health Organisation (2002) Reducing risks, promoting health life. The world health report. WHO, Geneva
National Center for Injury Prevention and Control (2000) WISQARS — Leading causes of death reports. CDC, Atlanta
Byard RW, Houldsworth G, James RA et al (2001) Characteristic features of suicidal drownings: a 20-year study. Am J Forensic Med Pathol 22:134–138
Mackie IJ (1999) Patterns of drowning in Australia, 1992–1997. Med J Aust 171:587–590
Cummings P, Quan L (1999) Trends in unintentional drowning: the role of alcohol and medical care. JAMA 281:2198–2202
Christe A, Aghayev E, Jackowski C et al (2008) Drowning-post-mortem imaging findings by computed tomography. Eur Radiol 18:283–290
Oliver WR, Chancellor AS, Soitys J et al (1995) Three-dimensional reconstruction of a bullet path: validation by computed radiography. J Forensic Sci 40:321–324
Andenmatten MA, Thali MJ, Kneubuehl BP et al (2008) Gunshot injuries detected by post-mortem multislice computed tomography (MSCT): a feasibility study. Leg Med (Tokyo) 10:287–292
Madea B, Henssge C, Lockhoven HB (1986) Priority of multiple gunshot injuries of the skull. Z Rechtsmed 97:213–218
Yen K, Lövblad KO, Scheurer E et al (2007) Post-mortem forensic neuroimaging: correlation of MSCT and MRI findings with autopsy results. Forensic Sci Int 173:21–35
Thali MJ, Yen K, Plattner T et al (2002) Charred body: virtual autopsy with multi-slice computed tomography and magnetic resonance imaging. J Forensic Sci 47:1326–1331
Wallace SK, Cohen WA, Stern EJ, Reay DT (1994) Judicial hanging: postmortem radiographic CT, and MR imaging features with autopsy confirmation. Radiology 193:263–267
Aghayev E, Yen K, Sonnenschein M et al (2005) Pneumomediastinum and soft tissue emphysema of the neck in postmortem CT and MRI: a new vital sign in hanging? Forensic Sci Int 153:181–188
Alfakih K, Plein S, Thiele H et al (2003) Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging 17:323–329
Hsu JC, Johnson GA, Smith WM et al (1994) Magnetic resonance imaging of chronic myocardial infarcts in formalin-fixed human autopsy hearts. Circulation 89:2133–2140
Jackowski C, Schweitzer W, Thali M et al (2005) Virtopsy: postmortem imaging of the human heart in situ using MSCT and MRI. Forensic Sci Int 149:11–23
Jauhiainen T, Jarvinen VM, Hekali PE (2002) Evaluation of methods for MR imaging of human right ventricular heart volumes and mass. Acta Radiol 43:587–592
Edwards JE (1970) The autopsy: do we still need it? Chest 57:113–114
Hull MJ, Nazarian RM, Wheeler AE et al (2007) Resident physician opinion on autopsy importance and procurement. Hum Pathol 38:342–350
Rutty GN, Duerden RM, Carter N, Clark JC (2001) Are coroners’ necropsies necessary? A prospective study examining whether a “view and grant” system of death certification could be introduced into England and Wales. J Clin Pathol 54:279–284
O’Mara MS, Battistella F (2004) Do we still need autopsies. Curr Surg 61:151–155
Vennemann B, Du Chesne A, Brinkmann B (2001) The practice of medical post-mortem examination. Dtsch Med Wochenschr 126:712–716
Burton EC, Phillips RS, Covinsky KE et al (2004) The relation of autopsy rate to physicians’ beliefs and recommendations regarding autopsy. Am J Med 117:255–261
Nakhleh R, Coffin C, Cooper K (2006) Association of directors of anatomic and surgical pathology. Recommendations for quality assurance and improvement in surgical and autopsy pathology. Hum Pathol 37:985–988
Thali MJ, Yen K, Vock P et al (2003) Image-guided virtual autopsy findings of gunshot victims performed with multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) and subsequent correlation between radiology and autopsy findings. Forensic Sci Int 138:8–16
Harke HT, Levy AD, Abbott RM et al (2007) Autopsy radiography: digital radiographs (DR) vs multidetector computed tomography (MDCT) in high velocity gunshot wound victims. Am J Forensic Med Pathol 28:13–19
Poulsen K, Simonsen J (2007) Computed tomography as routine connection with medico-legal autopsies. Forensic Sci Int 171:190–197
Pomara C, Marrone A, D’Errico S et al (2005) L’autopsia nelle morti da arma da fuoco: integrazione mediante TC spirale. Utile contributo? Riv It Med Leg 6:1131–1140
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Pomara, C., Fineschi, V., Scalzo, G. et al. Virtopsy versus digital autopsy: virtuous autopsy. Radiol med 114, 1367–1382 (2009). https://doi.org/10.1007/s11547-009-0435-1
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DOI: https://doi.org/10.1007/s11547-009-0435-1
Keywords
- Virtopsy
- Postmortem imaging
- Multislice computed tomography (MSCT)
- Magnetic resonance imaging (MRI)
- Noninvasive autopsy
- Forensic radiology
- Digital autopsy