Journal of Forensic Radiology and Imaging最新文献

Objective

Age estimation has important legal ramifications and assessing it, particularly in living adults, can prove challenging on occasion. This paper explores the use of gonial angle in age estimation, applying a new digital method which may be suitable in elderly subjects when many/all teeth are missing.

Materials and methods

A commercially available and ubiquitous software was used to measure the gonial angle on digital orthopantomographs from 100 subjects (48 males and 52 females; age range 18–89 years) which was subjected to linear regression analysis.

Results

The correlation coefficient for the gonial angle on the right side (r = 0.25) was greater than that for the left side (r = 0.23). Both correlations were statistically significant (p < 0.05). The regression equations derived were tested on a holdout sample (n = 17; age range 21–71 years) and revealed a mean absolute difference of approximately ± 14 years for the two regression equations.

Conclusion

Although the gonial angle may not consistently change with an increase in chronologic age, the digital method proposed here may be one of few options available for use in the elderly with minimal or no teeth seeking retirement benefits, and may be applied as a method of last resort in geriatric age prediction.

The identification of the skeletal and decomposing parts of human remains is still one of the most difficult skills in forensic medicine. An incomplete skeleton may represent a great challenge for forensic anthropologists. The aim of the present work has been to determine the accuracy of using the measurements of paranasal sinuses as a method for sex estimation, which uses Multi Detector Computed Tomography (MDCT). The study was carried out on 100 adult Egyptians (50 males and 50 females) who were referred to the Radio-Diagnosis Department of Alexandria University Hospitals in order to perform CT scans of the paranasal sinuses. For each participant, the lengths of 6 sphenoid sinus lines, maxillary sinus dimensions and frontal sinus dimensions were measured for both sides using MDCT. The study revealed that the mean lengths of right (Rt) lines 1, 3, 4, 5 and 6 and left lines (Lt) 1 and 4 of the sphenoid sinus were significantly larger in males than in females. Moreover, the mean lengths of the Rt depth, Lt depth and Lt height of the frontal sinus were significantly greater in males than in females. Additionally, the mean lengths of the Rt craniocaudal diameter, Rt depth, Rt width at the middle and intermaxillary distance of the maxillary sinus were significantly greater in males than in females. Logistic regression analysis was performed for sex estimation with an overall accuracy of 77%. It was concluded that the maxillary sinus shows the highest level of accuracy in sex estimation followed by the frontal sinus and then the sphenoid sinus using MDCT.

Objective

to investigate the volume and linear measurements of the frontal sinuses by means of a three-dimensional software using helical computed tomography images.

Materials and methods

The samples consisted of 36 tomographic images from 22 women and 14 men aged between 18 and 86 years old. The ITK/SNAP software was used for image segmentation, analysis of volume data, and linear measurements (i.e. height, width and depth).

Results

The mean volumes of the left and right frontal sinuses were 3.945 mm³ (SD = 2.803) and 3.423 mm³ (SD = 2.835). The mean linear measurements were the following: right-side axial depth of 16.1 mm (SD = 7.6), left-side axial depth of 17.0 mm (SD = 5.8), right-side sagittal height of 19.0 mm (SD = 11.1), and left-side sagittal height of 20.5 mm (SD = 9.8), with no statistically significant differences. The right-side axial width of 19.0 mm (SD = 6.8) and left-side axial width of 22.4 mm (SD = 9.1) in women and right-side axial width of 21.6 mm (SD = 12.9) and left-side axial width of 26.5 mm (SD = 9.8) in men, with statistically significant difference (P = 0.0264) for the left side.

Conclusion

There was a significant difference only for axial width, with the left side having higher values compared to the right side.

In this systematic review the diagnostic capabilities of post-mortem MR (PMMR) concerning brain and spinal cord abnormalities compared to traditional autopsy were analyzed.

A computerized online search of scientific articles was performed using Medline (PubMed) databases in June 2016 to identify all studies comparing PMMR with conventional autopsy in detecting fetal central nervous system alterations. Titles and abstracts were screened based on these exclusion criteria: no paediatric cases, neuroradiological alterations not reported, studies not in English, case reports and reviews, less than 10 subjects analyzed, PMMR performed on MR Units with magnetic field different from 1,5 or 3 T. Full texts of potentially relevant publications were read. Only articles with a clearly stated comparison between PMMR and autopsy results were included.

467 abstracts were identified; 14 papers met the inclusion criteria; data from 8 studies were extracted (467 cases). Of the 8 papers examined all regarded fetuses; only one analyzed also children <16 years. The percentages of concordance for pathology and general concordance between the two techniques were equal or superior to 90% in 7/8 and over 90% in 5/8 studies, respectively. In 5/7 works where the rating of false positives (FP) and false negatives (FN) was possible, FP numbers were superior to FN ones: in 72/467 cases (15%) PMMR suggested pathologies not confirmed by autopsy, in 27/467 cases (6%) autopsy showed alterations not detected by PMMR.

Based on these results, PMMR might be considered a valid support/substitute to traditional autopsy for studying fetal central nervous system.

Introduction

Post-mortem computed tomography (PMCT) and post-mortem magnetic resonance imaging (PMMR) are frequently used as an addition to autopsy. However, there is no research that determined the diagnostic value of these imaging techniques in forensic cases. The aim of this review is to evaluate the available literature with regard to the correlation between autopsy and imaging findings in the forensic investigation of gunshot victims to arrive at an the diagnostic value of PMCT and PMMR.

Materials & methods

The review process was set out as a systematic review according to the Cochrane guidelines. A systematic search was performed in MEDLINE and EMBASE to identify studies comparing autopsy and imaging techniques after fatal gunshot incidents. Autopsy and imaging techniques were compared for forensically relevant items: entrance wounds, exit wounds, trajectory of the bullet through the body, detection of metal fragments and identification of relevant injuries. The autopsy was the reference standard in all studies.

Results

In each study a minimum of one and a maximum of five items could be compared between the imaging techniques and the autopsy. In total seven studies complied with the inclusion criteria. The overall quality and level of detail of these studies did not allow for a formal meta-analysis. For the detection of the entrance wound five studies provide data and the correlation between imaging and autopsy was 100% in four studies, and 69.2% in one study. Five studies provide data on the exit wound and there was a 100% correlation in four, and 52.2% in one study. Six studies provide data on the bullet path and the correlation between techniques and autopsy was 100% in four studies and respectively 72.1% and 80% in the other two studies. For the detection of metal fragments three studies provide data and all these studies showed a 100% correlation between imaging and autopsy. Two studies provide data on detecting injuries with a correlation between imaging and autopsy of 100% and 87.2% respectively.

Conclusion

Despite the concerns on the quality of the reviewed studies, the literature shows that PMMCT has a high sensitivity in identifying the main forensic items in gunshot victims compared to the standard of reference; an autopsy. Forensic radiology and autopsy can be complementary in a forensic medical investigation.

Objectives

The changes of the body after death as visible on postmortem CT (PMCT) need to be differentiated as either normal postmortem physiology (such as hypostasis) or a sign of antemortem pathology (such as infection) or treatment (such as resuscitation). We investigated the subcutaneous and musculoskeletal tissues and correlated the attenuation with the postmortem interval (PMI) and pathology.

Methods

Cadavers that were donated to medical science, had a PMCT every hour. Clinical cadavers with a PMCT were included. The attenuation of subcutaneous and musculoskeletal tissues on the ventral and dorsal side of the body were measured. The PMI, temperature, antemortem infectious disease and attempted resuscitation were correlated to the attenuation. Anterior and posterior attenuation ratios were compared to determine gravitational effects over time.

Results

Five science cadavers were included with PMCT hourly from 4 to 48 h after death. 53 clinical cadavers were included. The ratio of ventral to dorsal muscle attenuation decreased over time in all five science cadavers. Attenuation of fat and musculoskeletal tissues showed large interpersonal differences without a consistent correlation to the PMI. Infectious cadavers showed some lower muscular attenuations than non-infectious cadavers. No attenuation effects of resuscitation could be found on PMCT.

Conclusion

Postmortem subcutaneous and musculoskeletal PMCT attenuation changes are common, however with substantial interpersonal differences. No correlation to PMI, body temperature or resuscitation was demonstrated. Infectious disease correlated to lower attenuation in some but not all muscles. Decreasing attenuation ratios in ventral-to-dorsal muscle tissue over the PMI may be a gravitational effect. Additional research is required to further explain the findings.

Post-mortem computed tomography (CT) is a valuable tool in forensic medicine. Determination of cause of death may require examination of a corpse found in a frozen state. However, most radiologists are unfamiliar with the post-mortem appearance of frozen organs on CT. Here we present two cases that included CT study of the frozen brain. Both bodies were naturally frozen, and autopsies showed that the cause of death was hypothermia in both instances. On post-mortem CT images, the frozen brains exhibited hypodense areas resembling infarctions, but these were not in regions dominated by blood vessels. Residual open sulci were evident, suggesting that oedema was absent. These two features are helpful when diagnosing a frozen brain on CT images.