The role of PMCT in firearm injuries. Case study.

Background: The use of radiological approaches in forensic investigations is rapidly emerging as an alternative to traditional autopsies. Here, we present the experience of the Sicilian and Calabrian forensic medical departments over the past five years, highlighting the application of PMCT to support autopsies in cases involving gunshot wound victims.

Materials and methods: From January 2020 to March 2024, thirty cadavers who died from gunshot wounds underwent total body PMCT examinations followed by autopsies. The examinations included multi-planar and 3D reconstructions. Data collected for each subject included gender, age, mode of death, type of weapon, number of shots, body sites affected, and presence of retained bullets. A team of two radiologists and two forensic physicians evaluated the images and compared them with the autopsy findings.

Conclusion: PMCT and 3D reconstruction enabled evaluation of entry wounds, fracture margins, injury sites, fragments, and anatomical trajectories. The results from PMCT were compared with autopsy findings in terms of entry wounds, wound channels, foreign bodies, organ and skeletal injuries, and causes of death. PMCT showed concordance with autopsy findings in determining the cause of death in all cases. The speed, non-invasiveness, and ability to manipulate and reconstruct data make PMCT an ideal technique for supporting forensic investigations and autopsies. PMCT is highly reliable for accurately identifying lethal wounds and determining the cause of death. It excels at tracking wound paths, distinguishing entrance and exit wounds, locating retained bullets, and detecting fragmentation and dispersion of ballistic components.