In situ temperature determination using magnetic resonance spectroscopy thermometry for noninvasive postmortem examinations.

Magnetic resonance spectroscopy (MRS) thermometry offers a noninvasive, localized method for estimating temperature by leveraging the temperature-dependent chemical shift of water relative to a temperature-stable reference metabolite under suitable calibration. Consequentially, this technique has significant potential as a tool for postmortem MR examinations in forensic medicine and pathology. In these examinations, the deceased are examined at a wide range of body temperatures, and MRS thermometry may be used for the temperature adjustment of magnetic resonance imaging (MRI) protocols or for corrections in the analysis of MRI or MRS data. However, it is not yet clear to what extent postmortem changes may influence temperature estimation with MRS thermometry. In addition, N-acetylaspartate, which is commonly used as an in vivo reference metabolite, is known to decrease with increasing postmortem interval (PMI). This study shows that lactate, which is not only present in significant amounts postmortem but also has a temperature-stable chemical shift, can serve as a suitable reference metabolite for postmortem MRS thermometry. Using lactate, temperature estimation in postmortem brain tissue of severed sheep heads was accurate up to 60 h after death, with a mean absolute error of less than 0.5°C. For this purpose, published calibrations intended for in vivo measurements were used. Although postmortem decomposition resulted in severe metabolic changes, no consistent deviations were observed between measurements with an MR-compatible temperature probe and MRS thermometry with lactate as a reference metabolite. In addition, MRS thermometry was applied to 84 deceased who underwent a MR examination as part of the legal examination. MRS thermometry provided plausible results of brain temperature in comparison with rectal temperature. Even for deceased with a PMI well above 60 h, MRS thermometry still provided reliable readings. The results show a good suitability of MRS thermometry for postmortem examinations in forensic medicine.

Whole-body non-forensic fetal virtopsy using postmortem magnetic resonance imaging at 7 Tesla vs classical autopsy.

OBJECTIVE: To determine the diagnostic accuracy of virtual autopsy using whole-body postmortem ultra-high field magnetic resonance imaging (MRI) at 7 Tesla (T), using a short T2-weighted imaging (T2-WI) protocol, compared with classical autopsy, for detecting structural abnormalities in small second-trimester fetuses. METHODS: Thirty consecutive fetuses at 13-19 weeks' gestation (weight, 17-364 g) were included following spontaneous pregnancy loss or termination of pregnancy. After fixation in 10% formaldehyde solution (48 h to 1 week), all fetuses were scanned using a two-dimensional turbo high-resolution T2-WI protocol with multislice relaxation time, followed by an invasive autopsy. The diagnostic accuracy of virtual autopsy vs classical autopsy was calculated for 990 anatomical structures (30 fetuses × 33 items). Sensitivity, specificity, positive and negative predictive values and Cohen's κ coefficient of agreement, with their 95% CIs, as well as the McNemar test, were used to evaluate the accuracy and agreement of the two diagnostic methods. Analysis was stratified by anatomical segment (nervous, pulmonary, cardiovascular, digestive, renal, facial and skeletal) and across three gestational-age intervals (13-14, 15-16 and 17-19 weeks). RESULTS: Considering classical autopsy as the gold standard, virtual autopsy had a sensitivity of 92.04% (95% CI, 85.42-96.29%) and a specificity of 97.87% (95% CI, 94.64-99.42%), with a positive predictive value of 96.30% (95% CI, 90.78-98.56%) and a negative predictive value of 95.34% (95% CI, 91.61-97.45%), achieving a diagnostic accuracy of 95.68% (95% CI, 92.73-97.68%) for detecting structural abnormalities in second-trimester fetuses. Cohen's κ for virtual vs classical autopsy was 0.907. The diagnostic ability of virtual autopsy at 7 T for malformed fetuses was superior to that of classical autopsy for analyzing the nervous system in small fetuses with pronounced autolysis, equivalent to that of classical autopsy when analyzing pulmonary, cardiovascular and renal systems and inferior when evaluating the fetal intestines. The sensitivity of virtual autopsy at 7 T for describing structural abnormalities increased with gestational age. CONCLUSION: Virtual fetal autopsy using 7-T MRI and a turbo high-resolution T2-WI protocol with multislice relaxation time is a feasible postmortem diagnostic tool for the identification of fetal structural anomalies. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Postmortem CT and autopsy findings in an elevator-related death: a case report.

Elevator-related fatalities and injuries are rarely discussed. Falls have been identified as the first cause of mortality in the majority of these accidents. Evidence suggests that many elevator accidents may be attributed to inadequate equipment maintenance or malfunctions of the devices. This study examines a case involving an elevator maintenance worker found within an elevator shaft, using postmortem computed tomography (PMCT) along with a full autopsy. The autopsy revealed that the cause of death was severe polytrauma resulting from dragging, compression, and crushing mechanisms, which resulted in a dislocated skull and multiple thoraco-abdominal injuries, including exposed organs and viscera. Detailed examination identified a cranio-encephalic crush, leading to a significant alteration in the physiognomy of the facial structures. Additionally, PMCT revealed complex spinal fractures, such as a Jefferson fracture and a complete Chance fracture at the D6 vertebra, accompanied by spinal deviation proximal to the fracture site. Autopsy findings corroborated these PMCT results. A multidisciplinary approach, including PMCT, is proposed as a strategic method for the comprehensive reconstruction of such accidents, facilitating the collection of extensive data.

Post mortem computed tomography meets radiomics: a case series on fractal analysis of post mortem changes in the brain.

Estimating the post-mortem interval is a fundamental, albeit challenging task in forensic sciences. To this aim, forensic practitioners need to assess post-mortem changes through a plethora of different methods, most of which are inherently qualitative, thus providing broad time intervals rather than precise determinations. This challenging problem is further complicated by the influence of environmental factors, which modify the temporal dynamics of post-mortem changes, sometimes in a rather unpredictable fashion. In this context, the search for quantitative and objective descriptors of post-mortem changes is highly demanded. In this study, we used computed tomography (CT) to assess the post-mortem anatomical modifications occurring in the time interval 0-4 days after death in the brain of four corpses. Our results show that fractal analysis of CT brain slices provides a set of quantitative descriptors able to map post-mortem changes over time throughout the whole brain. Although incapable of producing a direct estimation of the PMI, these descriptors could be used in combination with other more established methods to improve the accuracy and reliability of PMI determination.

An Indo-Pacific humpback dolphin (Sousa chinensis) severely injured by vessel collision: live rescue at sea, clinical care, and postmortem examination using a virtopsy-integrated approach.

BACKGROUND: Vessel collision induces blunt and sharp force traumas to aquatic animals and is a leading anthropogenic impact affecting cetaceans worldwide. Vessel collision is an important threat affecting vulnerable coastal cetaceans such as the Indo-Pacific humpback dolphins (Sousa chinensis) which reside in coastal waters of Hong Kong amongst heavy marine traffic. CASE PRESENTATION: A severely injured subadult S. chinensis was sighted in the waters off southwestern Hong Kong with four gaping incision wounds on its dorsum. It was in poor body condition and seemed unable to use the fluke effectively. The deepest wound located at the caudal peduncle near the base of the fluke and exposed the underlying fractured caudal vertebrae. The dolphin was monitored in the field over three weeks and eventually captured for medical intervention as veterinary assessment indicated progressive and life-threatening deterioration. During rehabilitation, the dolphin demonstrated initial signs of improvement over the first 36 hours as supported by diagnostic tests but then deteriorated rapidly. It was humanely euthanised after three days of rehabilitation. Postmortem investigation was carried out using virtopsy (postmortem computed tomography and magnetic resonance imaging) and conventional necropsy, with special attention to the traumatic musculoskeletal injuries caused by vessel collision and also revealed acute gastrointestinal compromise and respiratory disease that further hampered the rehabilitation. CONCLUSION: In cetaceans, the prognosis for recovery from injuries caused by vessel collision depends on the extent, location, and gravity of the injuries (i.e., superficial, deep, penetrating, blunt vs. sharp, fresh vs. septic), as well as the health status of the individual and its ability to respond to the insult. Injuries extending deep into the vertebral column may lead to delayed death and associated welfare issues. The prognosis of this case was likely poor given the severity and location of the injuries, but the attempted rehabilitation and postmortem investigation provided valuable insights for clinical management if similar cases are encountered in the future. Being able to non-invasively assess and document traumatic injuries and other pathologies, diagnostic imaging is particularly useful in the clinical assessment and postmortem investigation (virtopsy) of cases with vessel-induced injuries.

Post-mortem magnetic resonance imaging with computed tomography-guided biopsy for foetuses and infants: a prospective, multicentre, cross-sectional study.

BACKGROUND: Post-mortem imaging has been suggested as an alternative to conventional autopsy in the prenatal and postnatal periods. Noninvasive autopsies do not provide tissue for histological examination, which may limit their clinical value, especially when infection-related morbidity and mortality are suspected. METHODS: We performed a prospective, multicentre, cross-sectional study to compare the diagnostic performance of post-mortem magnetic resonance imaging with computed tomography-guided biopsy (Virtopsy®) with that of conventional autopsy in foetuses and infants. Cases referred for conventional autopsy were eligible for enrolment. After post-mortem imaging using a computed tomography scanner and a magnetic resonance imaging unit, computed tomography-guided tissue sampling was performed. Virtopsy results were compared with conventional autopsy in determining the likely final cause of death and major pathologies. The primary outcome was the proportion of cases for which the same cause of death was determined by both methods. Secondary outcomes included the proportion of false positive and false negative major pathological lesions detected by virtopsy and the proportion of computed tomography-guided biopsies that were adequate for histological examination. RESULTS: Overall, 101 cases (84 fetuses, 17 infants) were included. Virtopsy and autopsy identified the same cause of death in 91 cases (90.1%, 95% CI 82.7 to 94.5). The sensitivity and specificity of virtopsy for determining the cause of death were 96.6% (95% CI 90.6 to 98.8) and 41.7% (95% CI 19.3 to 68.0), respectively. In 32 cases (31.7%, 95% CI 23.4 to 41.3), major pathological findings remained undetected by virtopsy, and in 45 cases (44.6%, 95% CI 35.2 to 54.3), abnormalities were diagnosed by virtopsy but not confirmed by autopsy. Computed tomography-guided tissue sampling was adequate for pathological comments in 506 of 956 biopsies (52.7%) and added important diagnostic value in five of 30 cases (16.1%) with an unclear cause of death before autopsy compared with postmortem imaging alone. In 19 of 20 infective deaths (95%), biopsies revealed infection-related tissue changes. Infection was confirmed by placental examination in all fetal cases. CONCLUSIONS: Virtopsy demonstrated a high concordance with conventional autopsy for the detection of cause of death but was less accurate for the evaluation of major pathologies. Computed tomography-guided biopsy had limited additional diagnostic value. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01888380).

The Role and Place of Thanatoradiological Studies in the Pathological Examination of Fetuses and Newborns.

Analysis of published data on the possibilities of using postmortem radiation studies in perinatology is carried out and the results of own thanatoradiological studies of the bodies of dead fetuses and newborns are presented. The possibilities of postmortem radiation studies for differential diagnosis of stillborn and deceased newborns, evaluation of the severity of maceration and the time of intrauterine fetal death, detection of pathological changes in the brain and spinal cord, respiratory and digestive organs, in the cardiovascular and urinary systems were demonstrated. It is concluded that postmortem CT has a high diagnostic efficiency in the study of the bone skeleton, free fluid accumulations in serous cavities and gas in the vessels and tissues of dead fetuses and deceased newborns. The advantage of postmortem MRI is more effective visualization of internal organs and soft tissues, which allows assessing their topography and size, as well as identifying a wide range of pathological changes. For a comprehensive objective analysis of the bodies of stillborn and deceased newborns, combined use of both imaging methods (CT and MRI) is required. At the same time, thanatoradiology should be used as a part of a comprehensive pathological study, but not as a substitute for traditional autopsy.

[Postmortem assessment of cerebral edema]. / Posmertnaya otsenka oteka golovnogo mozga.

An analysis of literature data on the methods of post-mortem assessment of cerebral edema is presented. Based on the mechanisms of development, two main types of cerebral edema are distinguished: cytotoxic (intracellular) and vasogenic (extracellular). To determine cerebral edema, a number of methods are used, both direct and indirect, invasive and non-invasive assessment. Direct methods for assessing cerebral edema are based on determining the amount of water in its tissue. Indirect methods include morphological and radiation studies. Traditionally, the most evidence-based criteria for the diagnosis of cerebral edema are macroscopic and microscopic changes determined at autopsy. Methods are also indicated for determining the content of water in brain tissue by comparing the mass of wet and dry brain, as well as estimating the specific density of brain tissue.

Evaluation of the mediastinal-thoracic volume ratio on postmortem computed tomography.

OBJECTIVES: The aim of this study was to measure the mediastinal-thoracic volume ratio (CTR_VOL) on PMCT as a more accurate version of traditional CTR, in order to assess the terminal positional relationship between the heart and lungs in the different causes of death with regard to age, gender, BMI, cardiomegaly, and lung expansion. MATERIALS: Two hundred fifty consecutive postmortem cases with pre-autopsy PMCT and full forensic autopsy were retrospectively evaluated. The lungs and the mediastinum were manually segmented on the PMCT data and the correspondent volumes were estimated in situ. CTR_VOL was calculated as the ratio of the mediastinal to the thoracic volume. The volume measurements were repeated by the same rater for the evaluation of the intrarater reliability. Age, gender, body weight and height, heart weight at autopsy, and cause of death were retrieved from the autopsy reports. Presence of lung expansion was radiologically evaluated in situ. RESULTS: CTR_VOL was positively associated with age and BMI but not with gender and was higher for cardiomegaly compared to normal hearts, lower for asphyxiation-related deaths compared to cardiac deaths and intoxications, and lower for cases with lung expansion. The intrarater reliability was excellent for the calculated volumes of both lungs and mediastinum. CONCLUSION: The results of the present study support CTR_VOL as a tool to assess the relationship between the heart and lungs in situ, which differs significantly between the studied cause of death categories.

Update on the Diagnostic Pitfalls of Autopsy and Post-Mortem Genetic Testing in Cardiomyopathies.

Inherited cardiomyopathies are frequent causes of sudden cardiac death (SCD), especially in young patients. Despite at the autopsy they usually have distinctive microscopic and/or macroscopic diagnostic features, their phenotypes may be mild or ambiguous, possibly leading to misdiagnoses or missed diagnoses. In this review, the main differential diagnoses of hypertrophic cardiomyopathy (e.g., athlete's heart, idiopathic left ventricular hypertrophy), arrhythmogenic cardiomyopathy (e.g., adipositas cordis, myocarditis) and dilated cardiomyopathy (e.g., acquired forms of dilated cardiomyopathy, left ventricular noncompaction) are discussed. Moreover, the diagnostic issues in SCD victims affected by phenotype-negative hypertrophic cardiomyopathy and the relationship between myocardial bridging and hypertrophic cardiomyopathy are analyzed. Finally, the applications/limits of virtopsy and post-mortem genetic testing in this field are discussed, with particular attention to the issues related to the assessment of the significance of the genetic variants.

An algorithm for automatically generating gas, bone and foreign body visualizations from postmortem computed tomography data.

Post mortem computed tomography (PMCT) can aid in localizing foreign bodies, bone fractures, and gas accumulations. The visualization of these findings play an important role in the communication of radiological findings. In this article, we present an algorithm for automated visualization of gas distributions on PMCT image data of the thorax and abdomen. The algorithm uses a combination of region growing segmentation and layering of different visualization methods to automatically generate overview images that depict radiopaque foreign bodies, bones and gas distributions in one image. The presented method was tested on 955 PMCT scans of the thorax and abdomen. The algorithm managed to generate useful images for all cases, visualizing foreign bodies as well as gas distribution. The most interesting cases are presented in this article. While this type of visualization cannot replace a real radiological analysis of the image data, it can provide a quick overview for briefings and image reports.

Correlation of age, sex and season with the state of human decomposition as quantified by postmortem computed tomography.

Dead bodies exhibit a variable range of changes with advancing decomposition. To quantify intracorporeal gas, the radiological alteration index (RAI) has been implemented in the assessment of postmortem whole-body computed tomography. We used this RAI as a proxy for the state of decomposition. This study aimed to (I) investigate the correlation between the state of decomposition and the season in which the body was discovered; and (II) evaluate the correlations between sociodemographic factors (age, sex) and the state of decomposition, by using the RAI as a proxy for the extent of decomposition. In a retrospective study, we analyzed demographic data from all autopsy reports from the Institute of Forensic Medicine of Zurich between January 2017 to July 2019 and evaluated the radiological alteration index from postmortem whole-body computed tomography for each case. The bodies of older males showed the highest RAI. Seasonal effects had no significant influence on the RAI in our urban study population with bodies mostly being discovered indoors. Autopsy reports contain valuable data that allow interpretation for reasons beyond forensic purposes, such as sociopolitical observations.

Postmortem MRI Characterization of Cadaveric Hypostases in Deceased Newborns.

Using postmortem MRI, we studied the features of the development of internal cadaveric hypostasis in dead newborns. Postmortem radiological and pathoanatomical examination of 62 bodies of newborns and infants who died at the age of 1.5 h to 49 days was carried out. After the death was ascertained, prior to MRI, the bodies were stored in a refrigerator at 4°C in the supine position. Depending on the duration of the postmortem period (2-72 h), all observations were divided into eight groups. Prior to autopsy, an MRI scan was performed in T1 and T2 standard modes, followed by analysis of the presence and severity of the gradient line of the intensity of the MR signal in the liver and lung tissue in the ventral (overlying) and dorsal (underlying) areas, as well as the presence of a gradient of the intensity of the blood signal in the heart cavity and in the aortic lumen. The main manifestations of cadaveric hypostasis in the liver and lungs are changes of the MR signal intensity in the ventral and dorsal regions with the appearance of a horizontal gradient of the MR signal intensity, which reflects the location of the body after death. In the heart cavity and in the aortic lumen, there is also a gradient of the blood signal intensity of various severity with the visualization of two or three of its layers. The revealed features of the MRI signal intensity and, accordingly, the presence of its horizontal gradient depended not only on the MRI mode of the study, but also on the studied organ and the duration of the postmortem period. This should be taken into account when analyzing the results of virtopsy and determining the links of thanatogenesis of dead newborns and infants.

[Organization of postmortem radiological examination in the structure of pathological departments and forensic bureaus]. / Organizatsiya provedeniya posmertnykh luchevykh issledovanii v strukture patologo-anatomicheskikh otdelenii i byuro sudebno-meditsinskoi ekspertizy.

The purpose of this work is to develop an optimal scheme for organizing and conducting postmortem radiation studies in the Russian Federation based on literature data and our own results. One of the primary points in organizing virtopsiy is to determine the place where radiation examinations of deceased patients will be performed. The absence or presence of the equipment and capabilities available in the institution, i.e., the department of radiation diagnostics with functioning CT and MRI devices and software, determines the volume of economic costs. The analysis of the results of radiation research methods should be carried out by a highly qualified radiologist who has both general knowledge of radiation diagnostics and information about the radiation pattern of nonspecific postmortem changes. Based on our own experience in organizing postmortem radiation examinations, we consider it optimal to conduct postmortem CT and/or MRI scans by an X-ray technician in the radiation diagnostics department and to introduce a separate radiologist in the staffing of the pathology department or forensic medical examination bureau. In our opinion, an examination of the corpse by a radiologist in conjunction with a forensic expert is required to determine the most important areas of interest, tactics and methodology of radiation research. The final conclusion of the radiologist should be formed after consultation and agreement of the identified changes with a pathologist or forensic expert. Virtopsy is a highly effective objective method for examining a corpse. This dictates the need for its widespread introduction into the practice of the forensic medical examination bureaus and pathological and anatomical departments.

Noninvasive in situ proton MRS in muscle tissue and bone marrow as a novel approach to identify previous freezing in a completely thawed cadaver.

The temporary or permanent storage of human bodies in freezers following a homicide is a documented method for criminal disposal of human corpses. In these cases, the detection of characteristics which indicate that a thawed cadaver or body part was previously frozen provides crucial information for forensic casework. Previous histological and radiological approaches to detect characteristics of previous freezing are based on the formation of bubble-like gas patterns, which are difficult to distinguish from common postmortem gas formation in the course of decomposition. The objective of this study was to detect changes in the muscle tissue and in the bone marrow after freezing and thawing by means of in situ proton magnetic resonance spectroscopy (1 H-MRS) to provide a noninvasive approach to detect postfreezing alterations in human cadavers. In this experimental study, the hind legs of seven sheep were used as substitutes for human tissue. One hind leg underwent 1 H-MRS before and daily after storage in a deep freezer (-20°C) and complete thawing at room temperature (study group: n = 7). The opposite hind leg was kept at room temperature and was measured daily (control group: n = 7). Spectra and relaxation times were measured using single voxel measurements in the muscle tissue and in the bone marrow. 1 H-MRS revealed several changes in the muscle tissue and in the bone marrow after freezing and thawing. A strongly reduced peak area ratio (<20) between bulk methylene and olefinic and glycerol methine and a reduced T2 relaxation time for bulk methylene (<45 ms) measured in the bone marrow were found to be indicators that a sheep leg was previously frozen and thawed independent of the postmortem interval. Noninvasive in situ 1 H-MRS in the bone marrow potentially provides a new method for detecting previous freezing or extreme cooling in cadavers.

Postmortem CT in Trauma: An Overview.

As forensic radiology sees an exponential gain in popularity, postmortem computed tomography (PMCT) is increasingly being used in the appropriate setting, either as preautopsy guidance or as part of complementary virtual autopsy protocol. Many articles have expounded the value it adds to forensic pathology in the general setting and the appropriate technical parameters to be used for optimum benefit. We aim to put forth a concise review on the role of PMCT specifically in trauma and the pitfalls to be aware of. Reviews have shown that presumed cause of death in trauma have been proven by autopsy to be wrong in about 30% cases. Radiology applied to postmortem investigation in unnatural deaths and more specifically in trauma shares many semiotic features with emergency radiology. Therefore, in the near future, emergency radiologists might be required to integrate this type of imaging in their regular practice. Although the predominant drawbacks are time-dependent, PMCT also has some difficulty in differentiating antemortem and postmortem events. However, in many such scenarios, PMCT and autopsy play a complementary role in arriving at conclusions, and we believe understanding the benefits and role in trauma is imperative considering the expanding usage of PMCT.

POSTMORTEM COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING FINDINGS IN A CASE OF COINFECTION OF DOLPHIN MORBILLIVIRUS AND ASPERGILLUS FUMIGATUS IN A JUVENILE BOTTLENOSE DOLPHIN (TURSIOPS TRUNCATUS).

A freshly dead juvenile bottlenose dolphin (Tursiops truncatus), recovered from the waters near Sand Key, Clearwater, FL, was imaged postmortem using computed tomography and magnetic resonance imaging prior to conventional necropsy. The pattern of imaging findings in the brain was compatible with severe multifocal meningoencephalitis with intralesional necrosis and/or hemorrhage, and the pattern of imaging findings in the lungs was compatible with severe multifocal bronchopneumonia. The subsequent investigation included necropsy, histology, culture, and molecular diagnostics and demonstrated disseminated coinfection of dolphin morbillivirus and Aspergillus fumigatus. This is the first report documenting the cross-sectional imaging findings of this important cetacean comorbidity and demonstrates advances in modern, cooperative investigations of marine mammal mortality events.

The added value of postmortem magnetic resonance imaging in cases of hanging compared to postmortem computed tomography and autopsy.

The purpose of this study was to evaluate the added value of postmortem magnetic resonance imaging (MRI) compared to postmortem computed tomography (CT) and autopsy in cases of fatal hanging. In addition, the study analyzed the strengths of each examination method regarding typical injuries in these cases. We investigated a cohort of 25 decedents who underwent CT, MRI and autopsy. Two radiologists assessed all MR images of the head and neck as well as the corresponding CT images. The results were compared to autopsy findings by retrospectively analyzing the autopsy reports. Postmortem MRI revealed intramuscular hemorrhages in a large number of cases, however, autopsy did not confirm all of the detected hemorrhages. CT and autopsy detected fractures in several cases, whereas MRI showed a fracture in just one single case. Other previously described vital signs and relevant findings, such as fracture-related gas bubbles, soft tissue emphysema or pneumomediastinum, were observed in only a few individual cases. MRI provided added diagnostic value in the detection of soft tissue injuries and lymph node swelling in fatal hangings. As an adjunct to autopsy, postmortem MRI may reveal additional hemorrhages, which might be missed at autopsy. Since standard MRI demonstrated low sensitivity for the detection of fractures, an additional imaging modality or autopsy is required to overcome this limitation.

Noninvasive 7 tesla MRI of fatal craniocerebral gunshots - a glance into the future of radiologic wound ballistics.

Compared to computed tomography (CT), magnetic resonance imaging (MRI) provides superior visualization of the soft tissue. Recently, the first 7 Tesla (7 T) MRI scanner was approved for clinical use, which will facilitate access to these ultra-high-field MRI scanners for noninvasive examinations and scientific studies on decedents. 7 T MRI has the potential to provide a higher signal-to-noise ratio (SNR), a characteristic that can be directly exploited to improve image quality and invest in attempts to increase resolution. Therefore, evaluating the diagnostic potential of 7 T MRI for forensic purposes, such as assessments of fatal gunshot wounds, was deemed essential. In this article, we present radiologic findings obtained for craniocerebral gunshot wounds in three decedents. The decedents were submitted to MRI examinations using a 7 T MRI scanner that has been approved for clinical use and a clinical 3 T MRI scanner for comparison. We focused on detecting tiny injuries beyond the wound tract caused by temporary cavitation, such as microbleeds. Additionally, 7 T T2-weighted MRI highlighted a dark (hypo intense) zone beyond the permanent wound tract, which was attributed to increased amounts of paramagnetic blood components in damaged tissue. Microbleeds were also detected adjacent to the wound tract in the white matter on 7 T MRI. Based on the findings of radiologic assessments, the advantages and disadvantages of postmortem 7 T MRI compared to 3 T MRI are discussed with regard to investigations of craniocerebral gunshot wounds as well as the potential role of 7 T MRI in the future of forensic science.

Postmortem Computed Tomography Angiography of Newborns.

We propose an original method of postmortem computed tomography angiography of the body of a deceased newborn. The work is based on the analysis of the results of comprehensive postmortem computed tomography and pathological examination of 30 newborns, who died from congenital malformations. The key to a full-fledged postmortem radiation study using intravascular contrasting of deceased newborns and infants is the presence of vascular catheters established during life, as well as conducting it no earlier than 12 h and no later than 48 h after death. As a contrast agent, we recommend to use an iodine-containing water-soluble radiopaque drug containing at least 250 mg of iodine per 1 ml. The volume of contrast agent is calculated based on body weight, taking into account the general edema syndrome. The introduction of a contrast agent is carried out through vascular catheters in 3 stages in various positions of the body. The analysis of tomograms and 3D-reconstruction of blood vessels using their pseudocoloring allows accurate assessment of the topography of blood vessels with the possibility of separate study of the arterial and venous vessels, and to identify both congenital abnormalities of the heart and blood vessels, and their acquired pathology. CT angiography in some cases is superior to traditional autopsy in the diagnosis of blood vessel pathology. Postmortem CT angiography should be considered as an important stage of postmortem radiology in the structure of comprehensive pathological analysis of newborns and infants.