Zusammenfassung
Die postmortale Magnetresonanztomographie (MRT) des Gehirns kann eine wertvolle Ergänzung zur Obduktion sein. Eigene Untersuchungen beim kindlichen Schädel-Hirn-Trauma zeigten eine Übereinstimmung von 80% zwischen der forensisch neuropathologischen Untersuchung und der MRT. Die MRT lieferte ausgezeichnete Ergebnisse bei der Beurteilung von Blutungen unterschiedlicher Genese und der Darstellung von Sondenkanälen, erwies sich jedoch als unzureichend zur zuverlässigen Erkennung von Hirndruckzeichen. Die neuroradiologischen Untersucher sollten allerdings mit der forensischen Fragestellung vertraut sein und genaue Kenntnisse über das Auftreten und Bewerten postmortaler Artefakte besitzen. Zusammenfassend kann die postmortale MRT einen wichtigen Beitrag zur forensischen Neuropathologie leisten, die makroskopische und histologische Begutachtung jedoch nicht ersetzen.
Abstract
Postmortem magnetic resonance imaging (MRI) of the brain can be an important addition to a conventional forensic autopsy. Own investigations with respect to pediatric head trauma revealed an agreement between forensic neuropathological examination and MRI of 80%. There was a high sensitivity for MRI in detecting intracranial and intracerebral hemorrhages and the position of catheters but MRI failed in the reliable detection of signs of increased brain pressure. However, neuroradiologists should have basic forensic training and should be familiar with the phenomenon of postmortem artifacts. In conclusion, postmortem MRI may serve as an important tool in forensic neuropathology although it cannot replace a thorough macroscopical and histological examination.
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Büttner, A., Graw, M., Gora-Stahlberg, G. et al. Schädel-Hirn-Trauma im Kindesalter. Rechtsmedizin 21, 179–184 (2011). https://doi.org/10.1007/s00194-011-0750-4
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DOI: https://doi.org/10.1007/s00194-011-0750-4