Abstract
Introduction
Postmortem computed tomography (PMCT) data in gunshot-related death were evaluated by two reader groups and compared to the gold standard autopsy for the determination of forensic pathology criteria.
Materials and methods
Reader group I consisted of two board-certified radiologists whereas one board-certified radiologist and one board-certified forensic pathologist formed group II. PMCT data of 51 gunshot-related deaths were evaluated for the forensic pathology criteria number of gun shots, localization of gunshot injury, caliber, and direction of the gunshot differentiating between entry and exit wound as well as associated injury to surrounding tissue. The results of both reader groups were compared to the each other and to autopsy findings considered as gold standard.
Results
Reader groups I and II and as gold standard the autopsy evaluation showed in general a good correlation between all results. The overall discrepancy rate was 12/51 (23.4 %) cases for group I and 8/51 (15.6 %) for group II.
Discussion
Ultimately, the designated reader is able to draw the following conclusion from the presented data. At first, physical autopsy is better than PMCT regarding the localization of most gunshot injuries. Second, PMCT presents with better results than physical autopsy in locating fragmented bullets/fragment clouds, and finally, PMCT results of two radiologists were equivalent to the results of one evaluating radiologist and one pathologist with the exception of caliber assessment. However, referring to the pure numbers, the slight but not significant difference in the overall discrepancy rate of both reader groups might indicate the advantage of combining expertise in evaluating imaging in cases of gunshot-related death.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brogdon B (1998) Forensic radiology. CRC Press, Boca Raton
DiMaio VJ (2002) Gunshot wounds: practical aspects of firearms, ballistics, and forensic techniques. CRC press
Korac Z, Kelenc D, Baskot A, Mikulic D, Hancevic J (2001) Substitute ellipse of the permanent cavity in gelatin blocks and debridement of gunshot wounds. Mil Med 166(8):689–694
Thali MJ, Viner MD, Brogdon BG (2010) Brogdon’s forensic radiology. CRC Press
Andenmatten MA, Thali MJ, Kneubuehl BP, Oesterhelweg L, Ross S, Spendlove D, Bolliger SA (2008) Gunshot injuries detected by post-mortem multislice computed tomography (MSCT): a feasibility study. Legal Med (Tokyo, Japan) 10(6):287–292. doi:10.1016/j.legalmed.2008.03.005
Thali MJ, Yen K, Vock P, Ozdoba C, Kneubuehl BP, Sonnenschein M, Dirnhofer R (2003) Image-guided virtual autopsy findings of gunshot victims performed with multi-slice computed tomography and magnetic resonance imaging and subsequent correlation between radiology and autopsy findings. Forensic Sci Int 138(1-3):8–16
Harcke HT, Levy AD, Getz JM, Robinson SR (2008) MDCT analysis of projectile injury in forensic investigation. AJR Am J Roentgenol 190(2):W106–W111. doi:10.2214/ajr.07.2754
Makhlouf F, Scolan V, Ferretti G, Stahl C, Paysant F (2013) Gunshot fatalities: correlation between post-mortem multi-slice computed tomography and autopsy findings: a 30-months retrospective study. Legal Med (Tokyo, Japan) 15(3):145–148. doi:10.1016/j.legalmed.2012.11.002
Thomsen AH, Jurik AG, Uhrenholt L, Vesterby A (2009) An alternative approach to computerized tomography (CT) in forensic pathology. Forensic Sci Int 183(1-3):87–90. doi:10.1016/j.forsciint.2008.10.019
Thali MJ, Jackowski C, Oesterhelweg L, Ross SG, Dirnhofer R (2007) VIRTOPSY—the Swiss virtual autopsy approach. Legal Med (Tokyo, Japan) 9(2):100–104. doi:10.1016/j.legalmed.2006.11.011
Poulsen K, Simonsen J (2007) Computed tomography as routine in connection with medico-legal autopsies. Forensic Sci Int 171(2-3):190–197. doi:10.1016/j.forsciint.2006.05.041
Oehmichen M, Meissner C, Konig HG, Gehl HB (2004) Gunshot injuries to the head and brain caused by low-velocity handguns and rifles. A review. Forensic Sci Int 146(2-3):111–120. doi:10.1016/j.forsciint.2004.06.023
Thali MJ, Kneubuehl B, Vock P, Allmen G, Dirnhofer R (2002) High-speed documented experimental gunshot to a skull-brain model and radiologic virtual autopsy. Am J Forensic Med Pathol 23(3):223–228. doi:10.1097/01.paf.0000023002.14999.5e
Jacobsen C, Lynnerup N (2010) Craniocerebral trauma—congruence between post-mortem computed tomography diagnoses and autopsy results: a 2-year retrospective study. Forensic Sci Int 194(1-3):9–14. doi:10.1016/j.forsciint.2009.10.001
Grabherr S, Djonov V, Yen K, Thali MJ, Dirnhofer R (2007) Postmortem angiography: review of former and current methods. AJR Am J Roentgenol 188(3):832–838. doi:10.2214/ajr.06.0787
Filograna L, Tartaglione T, Filograna E, Cittadini F, Oliva A, Pascali VL (2010) Computed tomography (CT) virtual autopsy and classical autopsy discrepancies: radiologist’s error or a demonstration of post-mortem multi-detector computed tomography (MDCT) limitation? Forensic Sci Int 195(1-3):e13–e17. doi:10.1016/j.forsciint.2009.11.001
Bedford PJ, Oesterhelweg L (2013) Different conditions and strategies to utilize forensic radiology in the cities of Melbourne, Australia and Berlin, Germany. Forensic Sci Med Pathol 9(3):321–326. doi:10.1007/s12024-013-9424-8
Rutty GN, Gorincour G, Thali M (2013) Post-mortem cross-sectional imaging: are we running before we can walk? Forensic Sci Med Pathol 9(3):466. doi:10.1007/s12024-013-9464-0
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kirchhoff, S.M., Scaparra, E.F., Grimm, J. et al. Postmortem computed tomography (PMCT) and autopsy in deadly gunshot wounds—a comparative study. Int J Legal Med 130, 819–826 (2016). https://doi.org/10.1007/s00414-015-1225-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00414-015-1225-z