THE USING OF VIRTOPSIA IN FORENSIC MEDICAL EXAMINATION OF HANGING (literature review)

Abstract

Background. For the third decade in a row, forensic medical expertise in the world has been introducing and developing the use of virtopsia as a virtual alternative to traditional examination of corpse. It is believed that the combination of postmortem computed tomography (PMCT), postmortem magnetic resonance imaging (PMRI) 3D surface scanning and postmortem angiography is sufficient to replace the traditional autopsy with a virtual one. Yjwever, the practical experience of using virtopsia has revealed both its positive aspects and disadvantages that should be taken into account when using in practice. Aim: to study the peculiarities of the use of virtopsia in forensic medical examinations of corpses in general and in cases where the cause of death was mechanical asphyxia due to hanging. Material and methods: systematic review of electronic databases of medical and biological publications, bibliographic, analytical. Results. Virtopsia can be useful in cases of identification by dental status, in case of damage of the bones of the skull and in the diagnosis of craniocerebral injuries. Analysis of the role of PMCT in trauma and diagnostic features showed that the presumed cause of death as a result of trauma was proven in approximately 30% of cases. The properties of PMCT make it possible to use it in cases of drawing, in the examination of gunshot injuries to detect skeletal injuries in high-energy trauma and it can be used as a tool for selecting individual parts of the body for further detailed autopsy and reconstruction of the cause of events and finding the cause of death. In addition, it is advisable to use postmortem PMRI for the radiological assessment of gunshot wounds. Postmortem CT angiography is particularly useful for identifying vascular involvement and coronary death. During virtopsia signs of mechanical asphyxia, fractures of the hyoid bone, larynx or thyroid cartilage and intramuscular hemorrhages were revealed which can be used as an adjunct to the autopsy. A combined approach with radiological methods demonstrates the utility of a multidisciplinary approach to significantly reduce the number of unidentified injuries. Conclusion. Analysis of the literature suggests that both postmortem PMCT and PMRI have become widely used, but forensic medical examination of corpse is the gold standard for diagnosing injuries and determining of the cause of death yet. In cases of mechanical asphyxia due to hanging, it is advisable to use PMCT to detect injuries to the hyoid bone and cartilage of the larynx, and using PMRI to detect hemorrhages in the soft tissues of the neck. Detection of specific signs of perpetuity of neck tissue injury during mechanical asphyxia with the help of PMCT allows to improve the diagnosis of hanging by applying innovative technologies and using a multidisciplinary approach.