Postmortem Computed Tomography in Firearm Homicides: A Retrospective Case Series,

Abstract

Postmortem computed tomography (PMCT) is integrated into the evaluation of decedents in several American medical examiner offices and medicolegal death investigative centers in many other countries. We retrospectively investigated the value of PMCT in a series of firearm homicide cases from a statewide centralized medical examiner’s office that occurred during 2016. Autopsies were performed or supervised by board‐certified forensic pathologists who reviewed the PMCT scans prior to autopsy. PMCT scans were re‐evaluated by a forensic radiologist blinded to the autopsy findings and scored by body region (head–neck, thoracoabdominal, and extremities). Injury discrepancies were scored using a modified Goldman classification and analyzed with McNemar’s test. We included 60 males and 20 females (median age 31 years, range 3–73). Based on PMCT, 56 (79.1%) cases had injuries relevant to the cause of death in a single body region (24 head–neck region, 32 thoracoabdominal region). Out of these 56 cases, 9 had a missed major diagnosis by PMCT outside that region, including 6 extremity injuries visible during standard external examination. Yet all had evident lethal firearm injury. We showed that PMCT identifies major firearm injuries in homicide victims and excludes injuries related to the cause of death in other regions when a single body region is injured. Although PMCT has a known limited sensitivity for soft tissue and vascular pathology, it can be combined with external examination to potentially reduce or focus dissections in some of these cases depending on the circumstances and medicolegal needs.

The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

“…PMCT applications focus mainly on the analysis of non-natural death as cases related to a crime carried out by firearms, knives, and blunt instruments [ 9 , 10 ]. Moreover, several literature reports highlight the fundamental role of PMCT in traumatic events involving several persons as explosions, air and rail disasters, and shipwrecks [ 11 – 13 ].…”

Interpol review of forensic firearm examination 2019–2022

“…PMCT footage of 80 deceased victims of shooting incidents where evaluated retrospectively by an experienced radiologist, without having knowledge of case circumstances or autopsy findings [ 145 ]. Abnormalities were scored per region (head/neck, thorax/abdomen and extremities).…”

Post-mortem computed tomography in forensic shooting distance estimation: a porcine cadaver study

“…The estimation of shooting distance is commonly based on measurable evidence, e.g., gunshot residue analyzed by means of an automated image analysis [ 7 ]. Although computed tomography (CT) is often used to evaluate gunshot wounds in the forensic context [ 8 , 9 ], it is rarely utilized as a tool to estimate shooting distance [ 10 ].…”