Communicating 3D data-interactive 3D PDF documents for expert reports and scientific publications in the field of forensic medicine.

INTRODUCTION: Modern forensic investigations increasingly revert to 3D imaging techniques, such as computed tomography, magnetic resonance imaging, and 3D surface imaging. Findings are therefore often based on 3D data sets; however, this information is commonly reported and communicated within 2D imagery. The use of interactive 3D PDFs is already established in the scientific community but has yet to be implemented in the field of forensic medicine. METHODS AND MATERIALS: Three example cases were chosen to serve as exemplary data for the most commonly applied imaging techniques in postmortem imaging. 3D surface models were created from postmortem magnetic resonance imaging (PMMR), postmortem computed tomography (PMCT), and 3D surface imaging data sets. RESULTS: PMMR revealed a space-occupying subdural hemorrhage that led to ipsilateral compression of the brain tissue of the right hemisphere. PMCT displayed a defect in the skull on the left side of the temporal bone. 3D surface imaging data displayed a patterned discoloration on the inside of the left forearm. DISCUSSION: Interactive 3D PDFs offer the possibility to communicate 3D information to the reader while maintaining all the benefits of a regular 2D PDF. With Adobe Acrobat, the reader can interactively navigate through 3D data sets and create sufficient depth cues to generate a realistic 3D perception of the data. CONCLUSION: The interactive 3D PDF is a useful extension of standard 2D PDFs and has the potential to communicate 3D data to the reader in a more complete, more comprehensible, and less subjective manner than 2D PDFs.

Spa-drain entrapment complicated by suspicions of nonaccidental trauma and epilepsy onset.

We present here the case of an adolescent female near-drowning victim who was reportedly discovered submerged and unconscious by family members in a whirlpool spa. Physical examination revealed extensive posterior soft tissue bruising, which raised the suspicion of nonaccidental trauma. Detailed forensic evaluation of the injuries and the scene proved that the soft tissue findings represented an unusual manifestation of whirlpool-spa suction-vent injury. Medical evaluation indicated that epilepsy onset might have contributed to the near-drowning, although forensic evaluation of this possibility was less convincing. In this article we review these rare but important injuries, which have the potential to be confused with child abuse, and detail the atypical presentation and clinically presumed etiologic event in our case.

Postmortem whole-body CT angiography: evaluation of two contrast media solutions.

OBJECTIVE: The objective of our study was to establish a standardized procedure for postmortem whole-body CT-based angiography with lipophilic and hydrophilic contrast media solutions and to compare the results of these two methods. MATERIALS AND METHODS: Minimally invasive postmortem CT angiography was performed on 10 human cadavers via access to the femoral blood vessels. Separate perfusion of the arterial and venous systems was established with a modified heart-lung machine using a mixture of an oily contrast medium and paraffin (five cases) and a mixture of a water-soluble contrast medium with polyethylene glycol (PEG) 200 in the other five cases. Imaging was executed with an MDCT scanner. RESULTS: The minimally invasive femoral approach to the vascular system provided a good depiction of lesions of the complete vascular system down to the level of the small supplying vessels. Because of the enhancement of well-vascularized tissues, angiography with the PEG-mixed contrast medium allowed the detection of tissue lesions and the depiction of vascular abnormalities such as pulmonary embolisms or ruptures of the vessel wall. CONCLUSION: The angiographic method with a water-soluble contrast medium and PEG as a contrast-agent dissolver showed a clearly superior quality due to the lack of extravasation through the gastrointestinal vascular bed and the enhancement of soft tissues (cerebral cortex, myocardium, and parenchymal abdominal organs). The diagnostic possibilities of these findings in cases of antemortem ischemia of these tissues are not yet fully understood.

Postmortem angiography after vascular perfusion with diesel oil and a lipophilic contrast agent.

OBJECTIVE: The objective of our study was to establish optimal perfusion conditions for high-resolution postmortem angiography that would permit dynamic visualization of the arterial and venous systems. MATERIALS AND METHODS: Cadavers of two dogs and one cat were perfused with diesel oil through a peristaltic pump. The lipophilic contrast agent Lipiodol Ultra Fluide was then injected, and angiography was performed. The efficiency of perfusion was evaluated in the chick chorioallantoic membrane. RESULTS: Vessels could be seen up to the level of the smaller supplying and draining vessels. Hence, both the arterial and the venous sides of the vascular system could be distinguished. The chorioallantoic membrane assay revealed that diesel oil enters microvessels up to 50 microm in diameter and that it does not penetrate the capillary network. CONCLUSION: After establishing a postmortem circulation by diesel oil perfusion, angiography can be performed by injection of Lipiodol Ultra Fluide. The resolution of the images obtained up to 3 days after death is comparable to that achieved in clinical angiography.