Ultrasound Elastographic Measurement of Rigor Mortis in an Animal Model: A Feasibility Study for Improved Time-of-Death Estimates in Forensic Investigations

Kliewer, Mark A.; Mao, Lu; Weigman, Benjamin; Walker, Dana C.; Gettle, Lori Mankowski; Corliss, Robert F.

doi:10.2214/ajr.20.22915

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…3). As expected, the tissue properties of a cadaver had elevated SWV values 67,70 . The maximum load average SWV was 5.09 m/s.…”

Section: (2) Cadaveric Benchtop Studysupporting

confidence: 78%

“…This sub-study validated the linear relationship between tension and squared SWV in a human spinal cord. A live human spinal cord has drastically different acoustic and tissue properties than a fresh cooled cadaver 70,72 . Due to this, the absolute SWV in the baseline (non-stretched) cadaveric spinal cord was almost twice that of the non-stretched simulation and unstretched intraoperative cases.…”

Section: Discussionmentioning

confidence: 99%

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Quantifying tethered spinal cord tension: Ultrasound elastography results from computational, cadaveric, and intraoperative first-in-human studies

Kerensky

Paul²,

Routkevitch³

et al. 2023

Preprint

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Background Tension in the spinal cord is a trademark of tethered cord syndrome. Unfortunately, existing tests cannot quantify tension across the bulk of the cord, making the diagnostic evaluation of stretch ambiguous. A potential non-destructive metric for spinal cord tension is ultrasound-derived shear wave velocity (SWV). The velocity is sensitive to tissue elasticity and boundary conditions including strain. We use the term Ultrasound Tensography to describe the acoustic evaluation of tension with SWV. Methods Our solution “Tethered cord Assessment with Ultrasound Tensography (TAUT)” was utilized in three sub-studies: finite element simulations, a cadaveric benchtop validation, and a neurosurgical case series. The simulation computed SWV for given tensile forces. The induced tension cadaveric model validated the SWV-tension relationship. Lastly, SWV was measured intraoperatively in patients diagnosed with tethered cord who underwent surgical treatment (spinal column shortening). The surgery alleviates tension by decreasing the vertebral column length. Results Here we observe a strong linear relationship between tension and squared SWV across the preclinical sub-studies. Higher tension induces faster shear waves in the simulation (R2 = 0.984) and cadaveric (R2 = 0.951) models. The SWV decreases in all neurosurgical procedures (p<0.001). Moreover, TAUT has a c-statistic of 0.962 (0.92-1.00), detecting all tethered cords. Conclusions This study presents the first clinical metric of spinal cord tension. Strong agreement among computational, cadaveric, and clinical studies demonstrates the utility of ultrasound-induced SWV for quantitative intraoperative feedback. This technology is positioned to enhance tethered cord diagnosis, treatment, and post-operative monitoring as it differentiates stretched from healthy cords.

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“…3). As expected, the tissue properties of a cadaver had elevated SWV values 67,70 . The maximum load average SWV was 5.09 m/s.…”

Section: (2) Cadaveric Benchtop Studysupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Quantifying tethered spinal cord tension: Ultrasound elastography results from computational, cadaveric, and intraoperative first-in-human studies

Kerensky

Paul²,

Routkevitch³

et al. 2023

Preprint

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show abstract

“…Studies in a few animals, such as rats, pigs, and rabbits, have helped determine which factors can variate the time that Rigor mortis sets in, consequently delaying this mechanism, and the time it disappears. [4] Also, those same studies notice that it was highly affected by a lot of factors, for example environmental temperature, intoxication with stimulants, weight, or high fever before death, so basically everything that can cause reduction of ATP reserves [4,5]. Conclusion: To conclude, Rigor mortis is a lot more than just a contraction of both involuntary and voluntary muscles, it´s a complex biochemical mechanism that is very related with the decrease or increase of ATP [4].…”

Section: Introductionmentioning

confidence: 99%

Why rigor mortis and not just mortis?

Ferreira

2022

RevSALUS

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“…After death the percentage of ATP decreases from its normal level, and that´s when the phenomenon Rigor mortis starts [4]. It´s also important to acknowledge that this phenomenon can change its delay depending on a lot of factors, including, being in different countries due to different environmental temperatures [3,5].…”

mentioning

confidence: 99%

Blowflies’s (Diptera: Calliphoridae) nocturnal oviposition in Southern Europe (Portugal)

Fernandes

Castro

2022

RevSALUS

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ResumoIntroduction: Rigor mortis or postmortem rigidity is normally known as muscle contraction of the hole body, or just part of it, that happens because of the nucleotide ATP, also known as, adenosinetriphosphate, that decreases after death. [1-3] It´s often shown the importance of ATP in muscular contraction, because when a contraction occurs, it needs a sufficient amount of ATP stored in the muscle. Also, we know that it´s responsible for elasticity and softness of the muscles [1]. Objective: The main goal of this study was to gain knowledge about the meaning of Rigor mortis, and to learn why and when does it happen. Methods: A research was performed in the PubMed database between 1947 and 2021, using the terms "Rigor mortis", "Adenosinetriphosphate", and "Postmortem rigidity". Several studies about this theme appeared, explaining how this internal mechanism works and how it can help predict a lot of things during and investigation by forensics, being those the most focused articles. Results: There is a lot of intention understanding in what circumstances does this biochemical process happens. Studies in a few animals, such as rats, pigs, and rabbits, have helped determine which factors can variate the time that Rigor mortis sets in, consequently delaying this mechanism, and the time it disappears. [4] Also, those same studies notice that it was highly affected by a lot of factors, for example environmental temperature, intoxication with stimulants, weight, or high fever before death, so basically everything that can cause reduction of ATP reserves [4,5]. Conclusion: To conclude, Rigor mortis is a lot more than just a contraction of both involuntary and voluntary muscles, it´s a complex biochemical mechanism that is very related with the decrease or increase of ATP [4]. After death the percentage of ATP decreases from its normal level, and that´s when the phenomenon Rigor mortis starts [4]. It´s also important to acknowledge that this phenomenon can change its delay depending on a lot of factors, including, being in different countries due to different environmental temperatures [3,5].

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Ultrasound Elastographic Measurement of Rigor Mortis in an Animal Model: A Feasibility Study for Improved Time-of-Death Estimates in Forensic Investigations

Cited by 5 publications

References 15 publications

Quantifying tethered spinal cord tension: Ultrasound elastography results from computational, cadaveric, and intraoperative first-in-human studies

Quantifying tethered spinal cord tension: Ultrasound elastography results from computational, cadaveric, and intraoperative first-in-human studies

Why rigor mortis and not just mortis?

Blowflies’s (Diptera: Calliphoridae) nocturnal oviposition in Southern Europe (Portugal)

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