Correlations of Autopsy and Postmortem CT in Fatal Ballistic Injuries

Pierre Gach,Pierre Massiani,Guillaume Gorincour,Christophe Bartoli,Marie-Dominique Piercecchi,Lucile Tuchtan,Clémence Delteil,Julien Mancini

doi:10.3390/forensicsci2010015

Abstract

Purpose: To study the respective contributions and correlations of autopsy and PMCT in fatal ballistic injuries. Methods: A single-center retrospective descriptive study was carried out over a 10-years period (2008–2017) that included cases of fatal ballistic injuries that had undergone unenhanced PMCT followed by autopsy. In addition to demographics, the main data collected independently at autopsy and PMCT were the number of injuries, their trajectory, distances from the sole of the feet of the entry and exit wounds, projectile caliber and gunshot residue, detailed examination of the injuries, and detection of effusions. Results: Initially, 225 cases were included, of which 158 complete records were analyzed. The mean age of the victims was 41.5 years, and 93% were male. PMCT and autopsy findings were concordant concerning the number of injuries, their trajectory, and distance of the entry and exit wounds from the sole of the feet. Findings were not concordant regarding gunshot residues on the skin (autopsy more efficient) or detection of effusions (PMCT more efficient). The limitations of PMCT were the positioning of the limbs outside the field of acquisition and the impossibility of reliably determining the caliber of the projectiles. Some discrepancies were related to occasionally missing autopsy data, particularly the distance from the sole of the feet or measurements of the volume of effusion. Conclusions: This study provides more detailed knowledge of the accordance of autopsy and PMCT in analyzing fatal ballistic injuries.

Highlights

Medical imaging, and especially computed tomography (CT), is a tool whose contribution is recognized in forensic medicine, notably in the analysis of ballistic injuries [1–6]
We included all cases of fatal ballistic injuries that had undergone unenhanced postmortem CT (PMCT) followed by autopsy
We excluded cases where charring and/or putrefaction were too advanced for PMCT examination to be informative: those where the autopsy report was not yet available; those which, before PMCT and autopsy, had undergone surgery that could modify the characteristics of the injury; and those that had received more than 7 ballistic injuries

Summary

Introduction

Especially computed tomography (CT), is a tool whose contribution is recognized in forensic medicine, notably in the analysis of ballistic injuries [1–6]. Unlike autopsy, which is usually performed once, save from some exceptions, postmortem CT (PMCT) images can be reviewed, shared, or used as a source of demonstrative 3D images in a court setting [7]. Few large series evaluating the contribution of PMCT to the analysis of death by firearms have been published [8–11]. This tool is increasingly accessible worldwide, whether in regard to cost, speed of acquisition, or the number of devices. Our aim was to study the respective contributions and correlations between autopsy and PMCT findings in fatal ballistic injuries

Objectives

Methods

Results

Discussion

Conclusion