Can clinical CT data improve forensic reconstruction?

Abstract

In accidents resulting in severe injuries, a clinical forensic examination is generally abandoned in the initial phase due to high-priority clinical needs. However, in many cases, data from clinical computed tomography (CT) examinations are available. The goals of this prospective study were (a) to evaluate clinical CT data as a basis for forensic reconstruction of the sequence of events, (b) to assess if forensic radiological follow-up reading improves the forensic diagnostic benefit compared to the written clinical radiological reports, and (c) to evaluate if full data storage including additional reconstructed 0.6-mm slices enhances forensic analysis. Clinical CT data of 15 living individuals with imaging of at least the head, thorax, and abdomen following polytrauma were examined regarding the forensic evaluation of the sequence of events. Additionally, 0.6-mm slices and 3D images were reconstructed for forensic purposes and used for the evaluation. At the forensic radiological readings, additional traumatic findings were observed in ten of the 15 patients. The main weakness of the clinical reports was that they were not detailed enough, particularly regarding the localization of injuries and description of wound morphology. In seven cases, however, forensic conclusions were possible on the basis of the written clinical reports, whereas in five cases forensic reconstruction required specific follow-up reading. The additional 0.6-mm slices were easily available and with improved 3D image quality and forensic diagnostics. In conclusion, the use of clinical CT data can considerably support forensic expertise regarding reconstruction issues. Forensic follow-up reading as well as the use of additional thin slices for 3D analysis can further improve its benefit for forensic reconstruction purposes.

Use of 3D reconstruction of emergency and postoperative craniocerebral CT images to explore craniocerebral trauma mechanism

“…M. Thali et al [1] have employed the different image-scanning and 3D reconstruction approaches in forensic practices and have recognized the extensive application and great exploitation foreground. P. Schuh et al [6] indicate that the CT data is a valuable source of information for forensic reconstruction purposes in cases and the thinner slices are useful for the 3D image reading. M. Grassberger et al [12] regards the CT images and 3D reconstruction as the useful tool in clinical forensic casework.…”

“…Because of the high morbidity and mortality of craniocerebral trauma, the clinical emergency rescues are an immediate priority. Forensic experts are generally not involved into the case until later, maybe weeks or months [6]. When forensic pathologists confront these cases, especially when the victims survived after the trauma, there are not too many evidences for examinations because of injury healing and surgical operations etc.…”

“…Generally, the forensic experts will identify the injury mechanism by imaging diagnosis and 3D model resulted from the initial medical images. However, the clinicians are primarily focused on the trauma, therapeutic and prognostic implications, which lead to lack of detailed injury descriptions and sometimes the initial image thickness is not precise enough to reconstruct the original trauma [6]. Furthermore, craniocerebral trauma was the worst prognosis or even life-threatening, hence emergency surgery is needed to be operated to save the patient immediately, which will change the original trauma characteristics.…”

“…Medical imaging technologies have been an important and commonly used tool in forensic science [1][2][3][4][5][6], as it is nondestructive, visualizing, and documenting complete information [1]. In forensic autopsy practices, the forensic pathologist always needs to assess the injury locations, degrees and morphologies of soft tissues, bones and intracorporeal organs, to analyze the cause of death and injury mechanisms.…”

Klinisch-forensische Bildgebung

“…Abb. 4;[12]). Dass klinische radiologische Daten als Begutachtungsgrundlage eingesetzt werden, ist nicht neu.…”