Journal of Forensic Radiology and Imaging最新文献

Over the last decade, post-mortem computed tomography (PMCT) has been increasingly adopted within the forensic setting. The three-dimensional (3D) capability and non-destructive approach of PMCT allows it to have several advantages over conventional x-rays, and as such it may be of potential use within forensic odontology for disaster victim identification (DVI). However, the implementation of dental PMCT can only have a real forensic benefit if its accuracy is comparable to that of conventional post-mortem (PM) dental radiographs; which is currently standard practice. Therefore, the purpose of this review was to evaluate if dental PMCT is as accurate as PM dental radiographs. A review of the current literature has shown the accuracy of dental PMCT to be comparable or similar to that of PM dental radiographs. As a result, there is a potential for dental PMCT to replace conventional PM dental radiographs in the DVI process of Mass Fatality Incidents (MFIs). However, further research is required to establish an international standard protocol for dental PMCT before it can be recognised as a new standard practice within the forensic setting.

The fusion of antemortem and postmortem datasets may facilitate the radiological identification of decedents (RadID). Software for the image fusion is readily available from clinical radiology. This article demonstrates image fusions of three-dimensional datasets using medical image fusion software and describes RadID based on paranasal sinus, orthopedic implant, degenerative changes, healed fracture and dental positions by means of superimposed datasets (from computed tomography and magnetic resonance imaging).

Diabetes mellitus is a chronic, metabolic disease primarily defined by elevated levels of blood glucose. Long term effects of micro- and macrovascular damage may affect the cardio-vascular system, genitourinary tract, abdominal organs, nervous system, and musculoskeletal system. Diabetes can be challenging to detect at autopsy and if investigators are unaware of the medical history at the time of the autopsy the diagnosis may be missed. Postmortem computed tomography (PMCT) is able to detect a number of radiologic findings associated with diabetes, including obese stature, atherosclerosis, left ventricular hypertrophy, renal atrophy, residual opacification of the urinary tract from clinical CT, bladder over-distension, and calcification of the vas deferens. Signs of diabetes on pre-autopsy PMCT may direct additional investigations to confirm the diagnosis and account for the potential impact of diabetes on the cause of death.

This technical note describes a pump and catheter setup that is geared towards performing post mortem computed tomography angiography (PMCTA) examinations in fetal humans. With a voltage controlled very affordable immersion pump and a modified butterfly injection needle, relatively stable linear voltage flow rate relationships can be obtained across flow rates in the range of 30 to 150 ml/min. Flow rates are calculated and compared with actual measurements, whereas practical results suggest a degree of turbulence within the setup used. Practical testing with a fetal pig results in excellent vascular filling. This was subject to considerable partial volume effect, however, so using a micro computed tomography scanner for better quality scans of PMCTA for fetal humans is highly recommended.

We present a unique case of a four-week-old boy who died of a severe hypoxic encephalopathy due to a subdural hematoma. A week before his demise, a small left sided parieto-occipital subdural hemorrhage was seen on both CT and MRI. On the right side a larger, fronto-parietal subdural hemorrhage was present with a prominently defined protuberance to the right hemisphere, causing a midline shift to the left. Subdural hematomas have a broad differential diagnosis, including abusive head trauma which can have far reaching consequences. In order to diagnose the underlying cause of the subdural hematoma, and subsequently confirm or refute the differential diagnosis, a medicolegal autopsy was ordered. The autopsy revealed a rare primary intraosseous vascular malformation of the skull, at the location of the subdural hematoma. This, in combination with the coagulation disorder due to alpha-1-antitrypsin deficiency, was considered to be the underlying cause of death.

Objectives

to demonstrate the usefulness of 3D reconstructions to better understand the dynamic of a controlled bus bombing.

Materials and methods

3D models of the victims (pigs) were created from post-mortem CT scanning using Mimic software; 3D models of the crime scene (bus) were generated by means of photogrammetry and modelling techniques, using Photomodeler and 3Ds max software applications. Combinations and visualizations of the scene before and after the explosion were created using 3Ds max.

Results

several 3D reconstructions of the scene before and after the explosion were re-created to better visualize the dynamic of the incident and the blast injuries. All the pigs suffered extensive blast injuries. The bomb pig and the green pig (adjacent to the detonation site) underwent traumatic amputation and destruction due to a combination of blast injuries. Primary blast injuries and secondary injuries were found in all the other pigs. Fractures both due to tertiary or combined blast injuries were found in all the pigs except the yellow one (far from the detonation side). Three different “injury zones” could be identified based on the severity of the injuries of the pigs, as evaluated from autopsy and CT scanning.

Conclusion

3D reconstructions give a clearer and more comprehensive view of the scene and the victims, allowing a better understanding of the entire scene. CT scanning has proved to be an important tool in evaluating blast injuries in dead victims.