Postmortem Magnetic Resonance Imaging and Postmortem Computed Tomography in Ligature and Manual Strangulation

Area of Science:

• Forensic Radiology
• Medical Imaging
• Pathology

Background:

• Manual and ligature strangulation are forms of asphyxia with distinct postmortem findings.
• Radiological imaging plays a crucial role in the postmortem examination of strangulation cases.
• Evaluating the efficacy of different imaging modalities in detecting strangulation-related injuries is essential.

Purpose of the Study:

• To assess the findings of magnetic resonance imaging (MRI) in fatal manual or ligature strangulation.
• To compare the detectability of strangulation by computed tomography (CT), MRI, and autopsy.
• To verify strangulation evidence across different diagnostic methods.

Main Methods:

• Retrospective analysis of 6 manual and ligature strangulation cases (2013-2019).
• All cases underwent whole-body CT, head and neck MRI, and autopsy.
• Two radiologists reviewed imaging data and compared it with autopsy results.

Main Results:

• MRI demonstrated high accuracy in identifying intramuscular hemorrhages, confirmed by autopsy.
• Soft tissue injuries, indicative of strangulation, were detected by MRI even without external marks.
• CT successfully diagnosed fractures, including thyroid cartilage fractures.

Conclusions:

• MRI is a valuable tool for detecting soft tissue lesions in strangulation, serving as an alternative or adjunct to autopsy.
• Intramuscular hemorrhages are a key indicator of pressure applied to the neck in strangulation.
• CT or autopsy remains necessary for evaluating fractures in strangulation cases.