1.7. Use of radiopaque markers in reconstruction of gunshot injuries

Abstract

Objectives The identification of the trajectory of a projectile through the body is one of the most important issues to be solved in any case of gunshot injuries. Despite the advancements in modern cross-sectional imaging techniques those injuries still pose a challenge in forensic investigation. The exact identification of the entry and exit wound on the body surface, which is of great importance for the reconstruction of events, can be challenging on postmortem computed tomography (PMCT). This fact gives raise to requirement for an additional and highly reliable assisting technique. In response, a simple system was used, which adds information on entry and exit wound to standard PMCT images. Material and method A radiopaque rubber-seal ring was selected for external marking of gunshot wounds. It was placed around the wound and adhered to the body with double sided tape. A whole-body PMCT scan was performed after this preparation. Each ring was visible on the cross-sectional images surrounding the body surface wound, with the skin defect located centrally, and served as a permanent record of the anatomical location of the wound. Results This method has proven to be a quick and easy procedure for locating body surface gunshot wounds on PMCT scans. In contrast to other methods proposed for this purpose, this technique profits from higher accuracy and is non-invasive. The determination of the center of the rings allowed for identification of the entry and exit wound defects, contributing to the reconstruction of the injury. Conclusion The need for an accurate and simple method for marking entry and exit gunshot wounds was addressed yielding good results. It aids the initial investigation of gunshot injuries, as well as enables the three-dimensional visualization of acquired PMCT data.