Essentials of forensic post-mortem MR imaging in adults

Area of Science:

• Forensic Radiology
• Medical Imaging

Background:

• Post-mortem MRI (PMMR) has emerged as a significant diagnostic tool in forensic radiology over the last two decades.
• Its application as an adjunct or alternative to traditional autopsy varies based on jurisdictional practices, expert availability, and resources.

Purpose of the Study:

• To provide an overview of normal findings in forensic PMMR.
• To offer guidance on PMMR application in death investigations.
• To summarize current literature on PMMR applications in various body regions.

Main Methods:

• Review of existing literature on post-mortem MRI.
• Discussion of PMMR imaging techniques and interpretation.
• Focus on specific anatomical areas including head and neck, cardiovascular, abdominal, and musculoskeletal systems.

Main Results:

• PMMR is influenced by post-mortem changes; understanding normal variations is key to identifying pathology.
• Short tau inversion-recovery (STIR) sequences can identify pathological fluid accumulation (forensic sentinel sign).
• PMMR excels in visualizing brain, heart, abdominal organs, and skeletal injuries, potentially detecting ischemic injury earlier than autopsy.

Conclusions:

• PMMR is a powerful tool in forensic death investigations, offering detailed anatomical visualization.
• Familiarity with normal findings and specific techniques like STIR imaging enhances diagnostic accuracy.
• PMMR shows promise in early detection of ischemic injury, complementing traditional methods.