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The added value of postmortem magnetic resonance imaging in cases of hanging compared to postmortem computed

Eva Deininger-Czermak1,2, Jakob Heimer3, Carlo Tappero3,4

  • 1Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse, 190/52, CH-8057, Zurich, Switzerland. eva.deininger@irm.uzh.ch.

Forensic Science, Medicine, and Pathology
|March 30, 2020
PubMed

Insights

Postmortem MRI enhances the detection of soft tissue injuries and hemorrhages in fatal hanging cases. However, it shows low sensitivity for fractures, requiring complementary autopsy or CT scans.

Area of Science:

  • Forensic pathology
  • Medical imaging
  • Toxicology

Background:

  • Fatal hanging cases present diagnostic challenges.
  • Accurate identification of injuries is crucial for forensic investigations.
  • Conventional methods like autopsy and CT scans have limitations.

Purpose of the Study:

  • To evaluate the added value of postmortem magnetic resonance imaging (MRI) compared to postmortem computed tomography (CT) and autopsy.
  • To analyze the strengths of each examination method in detecting injuries specific to fatal hanging.
  • To determine the diagnostic utility of MRI as an adjunct to autopsy.

Main Methods:

  • A cohort of 25 decedents from fatal hanging cases was studied.
  • All decedents underwent postmortem CT, MRI, and autopsy.
  • Two radiologists assessed head and neck CT and MRI images, comparing findings to autopsy reports.

Main Results:

  • Postmortem MRI detected intramuscular hemorrhages not always confirmed by autopsy.
  • CT and autopsy identified fractures, while MRI showed only one fracture.
  • MRI demonstrated added value in detecting soft tissue injuries and lymph node swelling.
  • Vital signs like gas bubbles and emphysema were rarely observed across all methods.

Conclusions:

  • Postmortem MRI offers added diagnostic value for soft tissue injuries and hemorrhages in fatal hangings.
  • MRI's low sensitivity for fractures necessitates its use in conjunction with CT or autopsy.
  • Combined imaging and autopsy approaches can improve the comprehensive evaluation of fatal hanging cases.
Keywords:
Computed tomographyForensic radiologyHangingMagnetic resonance imagingPostmortemStrangulationVirtopsyVirtual autopsyVital sign

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