Noninvasive analysis and identification of an intramuscular fluid collection by postmortem 1H-MRS in a case of a fatal motor vehicle accident.
Int J Legal Med
; 134(3): 1167-1174, 2020 May.
Article
em En
| MEDLINE
| ID: mdl-31713679
ABSTRACT
In a case of a fatal traffic accident, a suspicious finding was identified in the muscular tissue of the left thigh by whole-body postmortem computed tomography. To better interpret the finding, the lower extremities were investigated by magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS). MRI revealed the presence of an evenly distributed intramuscular fluid and 1H-MRS of a volume within the fluid detected concentrations of acetate and lactate. The fluid was assumed to be an extravasation of an intraosseous infusion, erroneously administered to the intermediate vastus of the left thigh during resuscitation, which was later confirmed when access to resuscitation protocols was granted. Further ex situ 1H-MRS investigations of five different infusion fluids showed the possible discrimination of the fluids and further indicated the unknown fluid to be a Ringer's acetate solution. This paper presents the case-based application of postmortem intramuscular 1H-MRS and introduces the possibility of its use to differentiate exo- and endogenic fluids for forensic interpretation. Further research for this method regarding problems in forensic pathology is needed.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Coxa da Perna
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Acidentes de Trânsito
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Infusões Intraósseas
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Espectroscopia de Prótons por Ressonância Magnética
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Soluções Isotônicas
Tipo de estudo:
Diagnostic_studies
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Prognostic_studies
Limite:
Child
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Humans
Idioma:
En
Revista:
Int J Legal Med
Ano de publicação:
2020
Tipo de documento:
Article