1.4. Comparison between radiologist and pathologist in determining trajectories in gunshot victims

Abstract

Purpose Traditionally the pathologist describes gunshot trajectories as a part of the post-mortem examination in gunshot victims. Forensic radiology has shown to be accurate in determining the trajectories using computed tomography (CT). The goal of this study is to investigate if there are discrepancies between the trajectories describe by the pathologist and radiologist and if these discrepancies can be attributed to characteristics of the trajectory. Subjects and methods The data of all shooting incidents between 2010 and 2013 were collected, in which both a forensic radiological and pathological examination were performed by means of a total body CT-scan and a full post mortem respectively. From the final independent report of these examinations we determine the number of trajectories, the tract of the trajectories, if these trajectories crossed the lung, abdomen, skull, spine, bone and whether the trajectory was linear. Results The data of 13 incidents were collected with a total of 48 trajectories. Nine trajectories went through the lung, seven through the abdomen, thirty through bone, six through the spine and 10 through the head. In 19 out of the 48 trajectories there was a discrepancy between the radiologist and the pathologist. There was no association between the course of the trajectory and the discrepancies. Conclusion In almost 40% of the trajectories there is a discrepancy between the radiologist and pathologist. The literature shows that radiology has a higher diagnostic value for determining a trajectory. A more detailed analysis of each trajectory is needed to determine the cause of the discrepancies.