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Postmortem imaging as a complementary tool for the investigation of cardiac death

Forensic Sciences Research 2019年第3期4卷 211-222页

作者： Katarzyna Michaud Pia Genet Sara Sabatasso silke grabherr Lausanne University Hospital and University of Lausanne University Center of Legal Medicine Lausanne-GenevaLausanneSwitzerland Geneva University Hospital University Center of Legal Medicine Lausanne-GenevaGenevaSwitzerland

In the past 2 decades,modern radiological methods,such as multiple detector computed tomography (MDCT),MDCT-angiography,and cardiac magnetic resonance imaging (MRI)were introduced into postmortem practice for investigation of sudden death (SD),including cases of sudden cardiac death (SCD).In forensic cases,the underlying cause of SD is most frequently cardiovascular with coronary atherosclerotic disease as the leading *** are many controversies about the role of postmortem imaging in establishing the cause of death and especially the value of minimally invasive autopsy *** paper discusses the state of the art for postmortem radiological evaluation of the heart compared to classical postmortem examination,especially in cases of *** SCD cases,postmortem CT is helpful to estimate the heart size and to visualize haemopericardium and calcified plaques and valves,as well as to identify and locate cardiovascular *** methods are useful to provide a detailed view of the coronary arteries and to analyse them,especially regarding the extent and location of stenosis and *** postsurgical cases,it allows verification and documentation of the patency of stents and bypass grafts before opening the *** MRI is used to investigate soft tissues such as the myocardium,but images are susceptible to postmortem changes and further work is necessary to increase the understanding of these radiological aspects,especially of the ischemic *** postsurgery cases,the value of postmortem imaging of the heart is reportedly for the diagnostic and documentation *** implementation of new imaging methods into routine postmortem practice is challenging,as it requires not only an investment in equipment but,more importantly,investment in the expertise of interpreting the *** those requirements are implemented,however,they bring great advantages in investigating cases of SCD,as they allow documentation of the body,ori

关键词： Forensic sciences forensic pathology sudden cardiac death postmortem imaging postmortem CT-angiography minimally invasive autopsy autopsy

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A fatal case of oxygen embolism in a hospital

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Forensic Sciences Research 2017年第2期2卷 100-106页

作者： Lionel Comment Vincent Varlet Kewin Ducrot silke grabherr Forensic Medicine Unit University Center of Legal MedicineCHUV HospitalLausanne-GenevaSwitzerland Forensic Toxicology and Chemistry Unit University Center of Legal MedicineCHUV HospitalLausanne-GenevaSwitzerland Unit of Forensic Imaging and Anthropology University Center of Legal MedicineCHUV HospitalLausanne-GenevaSwitzerland

This case reports on a 68-year-old man who was found dead in hospital next to his *** this,he had been treated with intravenous antibiotics for *** body was found with a peripheral venous catheter connected to a nasal cannula delivering oxygen(O_(2))from the *** medico-legal examinations were performed,including post-mortem computed tomography(CT),complete conventional autopsy,histological and immunohistochemistry analysis,toxicological analysis and post-mortem ***,CT-guided gas sampling was performed at multiple sites to collect samples for gas *** the external examination,massive subcutaneous emphysema was visible over the entire surface of the *** CT scan revealed the presence of gas throughout the vascular system,and in the subcutaneous and muscular *** autopsy confirmed the presence of lobar pneumonia and multiple gas bubbles in the vascular *** gas analysis results showed a subnormal concentration of oxygen,confirming the suspected pure O_(2) ***,the carbon dioxide(CO_(2))concentration in the gas sample from the heart was elevated to a level similar to those found in scuba diving *** could come from degassing of dissolved CO_(2) that accumulated and was trapped in the cardiac *** on the results of the different exams performed,and especially the gas analysis results,it was concluded that the cause of death was O_(2) embolism.

关键词： Forensic science air embolism autopsy forensic imaging gas analysis

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Oleic Acid (OA), A Potential Dual Contrast Agent for Postmortem MR Angiography (PMMRA): A Pilot Study

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Current Medical Science 2020年第4期40卷 786-794页

作者： Zhi-yuan XIA Christine BRUGUIER Fabrice DEDOUIT silke grabherr Marc AUGSBURGER Bei-bei LIU Institute of Evidence Law and Forensic Science China University of Political Science and Law(CUPL)Key Laboratory of Evidence Law and Forensic ScienceMinistry of EducationBeijing 100088China University Center of Legal Medicine Lausanne-Geneva(CURML)Lausanne CH1000Switzerland Service de Mede cine Legale Hopital de RangueilToulouse 50032France Dian Research Center for Postmortem Imaging&Angiography Beijing 100192China

Summary:Choosing proper perfusates as contrast agents is an important aspect for postmortem magnetic resonance angiography(PMMRA).However,in this emerging field,the number of suitable kinds of liquid is still very *** objective of this research is to compare MR images of oleic acid(OA)with paraffin oil(PO)in vitro and in ex situ animal hearts,in order to evaluate the feasibility to use OA as a novel contrast agent for *** vitro,OA,PO and water(control)were introduced into three tubes separately and T,weighted-spin echo(Tw SE)and T2w-SE images were acquired on a 1.5T MR *** the second experiment,0A and PO were injected into left coronary artery(LCA)and left ventricle(LV)of ex situ bovine hearts and their Tw-SE,Tzw-SE,Tw-multipoint Dixon(Tjw-mDixon)and 3DT2w-mDixon images were *** overall results indicate that OA may have a potential to be used as a dual(T and T2 based)contrast agent for PMMRA when proper sequence parameters are ***,as the pilot study was based on limited number of animal hearts,more researches using OA in cadavers are needed to validate our findings.

关键词： postmortem magnetic resonance angiography perfusate contrast agent oleic acid paraffin oil heart

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Virtual anthropology:a preliminary test of macroscopic observation versus 3D surface scans and computed tomography(CT)scans

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Forensic Sciences Research 2021年第1期6卷 34-41页

作者： Claudine Abegg Ilaria Balbo Alejandro Dominguez silke grabherr Lorenzo Campana Negahnaz Moghaddam Unit of Forensic Imaging and Anthropology University Center of Legal Medicine Lausanne-GenevaLausanneSwitzerland Dipartimento di Scienze biologiche Universita di BolognaBolognaItaly School of Health Sciences(HESAV) University of Applied Sciences and Arts Western Switzerland(HES-SO)DelemontSwitzerland Swiss Human Institute of Forensic Taphonomy LausanneSwitzerland

Virtual anthropology(VA)is based on applying anthropological methods currently used to analyse bones to 3D models of human *** great advances have been made in this endeavour in the past decade,several interrogations concerning how reliable these models are and what their proper use should be remain *** this research,a fundamental assumption of VA has been investigated:if the way we perceive and apply an anthropological method is truly similar when looking at bones macroscopically and through various 3D *** order to answer,10 skulls of known age and sex were scanned using a computed tomography(CT)scanner and a 3D surface *** observers separately applied a defined staging method to eight suture sites on these skulls,first looking at the bone macroscopically,then at the 3D surface scan,and finally on the CT *** rounds of observation were carried out by each ***-and inter-observer error were evaluated,and two sample t-tests used to evaluate if the different types of medium used yielded significantly different *** results show a high degree of inter-observer error,and that data obtained from 3D surface scans differ from macroscopic observation(confidence level 95%,P≤0.05).CT scans,in these settings,yielded results comparable to those obtained through macroscopic *** results offer many possibilities for future research,including indications on the kind of anthropological methods and anatomical landmarks that might be reliably transferable to the virtual *** current methods used in traditional anthropology should be tested,and if they prove unreliable,new techniques to analyse bones from virtual models should be developed.

关键词： Forensic sciences virtual anthropology CT scan 3D surface scan forensic anthropology cranial sutures

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Modern post-mortem imaging:an update on recent developments

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Forensic Sciences Research 2017年第2期2卷 52-64页

作者： silke grabherr Coraline Egger Raquel Vilarino Lorenzo Campana Melissa Jotterand Fabrice Dedouit University Centre of Legal Medicine Lausanne-Geneva LausanneSwitzerland Service of Legal Medicine Central Institute of HospitalsSionSwitzerland

Modern post-mortem investigations use an increasing number of digital imaging methods,which can be collected under the term“post-mortem imaging”.Most methods of forensic imaging are from the radiology field and are therefore techniques that show the interior of the body with technologies such as X-ray or magnetic resonance *** digitally image the surface of the body,other techniques are regularly applied,***-dimensional(3D)surface scanning(3DSS)or ***’s most frequently used techniques include post-mortem computed tomography(PMCT),post-mortem magnetic resonance imaging(PMMR),post-mortem computed tomographic angiography(PMCTA)and 3DSS or *** of these methods has specific advantages and ***,the indications for using each method are *** PMCT gives a rapid overview of the interior of the body and depicts the skeletal system and radiopaque foreign bodies,PMMR allows investigation of soft tissues and parenchymal *** is the method of choice for viewing the vascular system and detecting sources of ***,none of those radiological methods allow a detailed digital view of the body’s surface,which makes 3DSS the best choice for such a *** 3D surface scanners are not available,photogrammetry is an *** review article gives an overview of different imaging techniques and explains their applications,advantages and *** hope it will improve understanding of the methods.

关键词： Forensic science forensic imaging post-mortem radiology post-mortem computed tomography post-mortem magnetic resonance imaging 3D scanning post-mortem angiography photogrammetry

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CT-scan vs.3D surface scanning of a skull:first considerations regarding reproducibility issues

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Forensic Sciences Research 2017年第2期2卷 93-99页

作者： Stella Fahrni Lorenzo Campana Alejandro Dominguez Tanya Uldin Fabrice Dedouit Olivier Deleemont silke grabherr School of Criminal Justice University of LausanneLausanne-DorignySwitzerland Department of Forensic Imaging University Centre for Legal Medicine Lausanne-GenevaLausanneSwitzerland Department of Technological Radiology Health School of Sciences Vaud-HESAVLausanneSwitzerland

Three-dimensional surface scanning(3DSS)and multi-detector computed tomography(MDCT)are two techniques that are used in legal medicine for digitalizing objects,a body or body parts such as *** these techniques are more and more commonly employed,surprisingly little information is known about the quality rendering of digitalized three-dimensional(3D)models provided by each of *** paper presents findings related to the measurement precision of 3D models obtained through observation of a study case,where a fractured skull reconstructed by an anthropologist was digitalized using both post-mortem imaging *** tomography(CT)scans were performed using an 8-row MDCT unit with two different slice *** variability of 3D CT models superimposition allowed to assess the reproducibility and robustness of this digitalization ***,two 3D surface scans were done using a professional high resolution 3D *** comparison of 3D CT-scans with 3D surface scans by superimposition demonstrated several regions with significant differences in topology(average difference between+1.45 and-1.22 mm).When comparing the reproducibility between these two digitalizing techniques,it appeared that MDCT 3D models led in general to greater variability for measurement precision between scanned ***,the reproducibility was better achieved with the 3D surface digitizer,showing 3D models with fewer and less pronounced differences(from+0.32 to-0.31 mm).These experiments suggest that MDCT provides less reproducible body models than 3D surface *** further studies must be undertaken in order to corroborate this first impression,and possibly explain the reason for these findings.

关键词： Forensic imaging multi-detector computed tomography(MDCT) 3D surface scanning anthropology

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Neck-MRI experience for investigation of survived strangulation victims

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Forensic Sciences Research 2020年第2期5卷 113-118页

作者： Christine Bruguier Pia Genet Jean-Baptiste Zerlauth Fabrice Dedouit Jochen Grimm Reto Meuli Tony Fracasso silke grabherr University Center of Legal Medicine Lausanne–Geneva University Hospital LausanneLausanneSwitzerland Department of Diagnostic and Interventional Radiology University Hospital LausanneLausanneSwitzerland Clinique Cecile LausanneSwitzerland

For the medicolegal evaluation of victims of survived strangulation,a neck-magnetic resonance imaging(MRI)can be performed for assessing lesions in the inner soft tissues(fat,muscles or lymph nodes,for example).In our institute,such MRI examinations have been performed for a test period of 4 years with the aim of evaluating the use of this tool by forensic pathologists and identifying medicolegal indicators for the performance of neck-MRI in surviving victims of *** retrospectively reviewed medicolegal reports from all victims examined during the test *** extracted objective lesions(***,bruising and abrasions)and reported clinical symptoms(*** disorder,dysphasia)from the *** findings were compared to those reported from the *** total,112 victims were clinically examined after suspected *** of these victims underwent an MRI examination of the ***-four of the victims presented objective lesions during the clinical examination,with eight showing signs of both petechiae and ***-MRI was performed in four of these eight victims and three of them showed lesions visible in *** 76 victims with bruising as the only objective finding,66 victims described clinical *** those 66 victims,seven were examined by MRI and two demonstrated lesions in *** MRI was performed,relevant findings were detected in 45%of the *** leads to the suspicion that many more findings could have been detected in the other victims,if an MRI had been performed in those *** results lead us to the conclusion that an MRI examination of victims of suspected strangulation is useful,and strict indications for its application should be established.

关键词： Forensic sciences forensic pathology neck-MRI radiological findings medicolegal evaluation strangulation survivors

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Sex estimation in a Turkish population using Purkait’s triangle:a virtual approach by 3-dimensional computed tomography(3D-CT)

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Forensic Sciences Research 2022年第2期7卷 97-105页

作者： Julieta G.García-Donas Suna Ors Ercan Inci Elena F.Kranioti Oguzhan Ekizoglu Negahnaz Moghaddam silke grabherr Centre for anatomy and human identification school of science and engineeringUniversity of DundeescotlandUK Department of radiology Bakirkoy Training and research hospitalistanbulTurkey Department of Forensic science University of cretecreteGreece University center of Legal Medicine Lausanne-Geneva Lausanneswitzerland Unit of Forensic imaging and anthropology University center of Legal Medicine Lausanne-GenevaLausanneswitzerland Swiss human institute of Forensic Taphonomy University center of Legal Medicine Lausanne-GenevaLausanneswitzerland

Sex estimation is considered one of the first steps in the forensic identification *** and morphometrical differences between males and females have been used as means for morphoscopic and metric methods on both cranial and postcranial skeletal *** dry skeletal elements are not available,virtual data can be used as a *** present research explores 3-dimensional(3D)scans from a Turkish population to test a sex estimation method developed by Purkait(2005).Overall,296 individuals were used in this study(158 males and 138 females).Purkait’s triangle parameters were measured on computed tomography(CT)scans obtained from both right and left femora of each patient at the Bakirkoy *** Konuk Training Research Hospital(Istanbul,Turkey).Intra-and inter-observer errors were assessed for all variables through technical error of measurements *** asymmetry and sex differences were evaluated using parametric and non-parametric statistical *** and multivariate discriminant function analyses were then *** errors demonstrated an overall agreement within and between experts,as indicated by technical error of measurement(TEM)*** bilateral asymmetries were reported,and all parameters demonstrated a statistically significant difference between males and *** discriminant models were generated by applying single and combined parameters,producing a total correct sex classification ranging from 78.4%to 92.6%.In addition,over 67%of the total sample was accurately classified,with 95%or greater posterior *** study demonstrates the feasibility of 3D sex estimation using Purkait’s triangle on a Turkish population,with accuracy rates comparable to those reported in other *** is the first attempt to apply this method on virtual data and although further validation and standardisation are recommended for its application on dry bone,this research constitutes a signif

关键词： Forensic sciences forensic anthropology sex estimation computed tomography Purkait’s triangle

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Forensic imaging

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Forensic Sciences Research 2017年第2期2卷 51-51页

作者： silke grabherr University Centre of Legal Medicine Lausanne-Geneva LausanneSwitzerland

The useofimagestoexplainanddocument findings for forensicandmedico-legalpurposesisasoldasthe discipline ***,imagesseemanexcellentcom-plement ***,imaging techniques complete findings obtainedtodaybycon-ventional examinationsastheyhavedonesincethe very *** lesions orcrimesceneswere first drawnbythemedical ***,photographswereusedtodocument important medico-legal findings.

关键词： finding legal Schema

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基于纳米磁流体尸体磁共振成像血管造影的可行性研究

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中国法医学杂志 2020年第6期35卷 576-581页

作者：夏志远 Christine Bruguier Fabrice Dedouit silke grabherr Marc Augsburger 刘蓓蓓浙江迪安鉴定科学研究院迪安鉴定虚拟解剖研究中心浙江杭州310000 洛桑和日内瓦大学法医中心瑞士洛桑CH1000 兰格勒医院法医学服务中心法国图卢兹50032

目的初步探究纳米磁流体(magnetic nanoparticle ferrofluid,MNPF)在尸体磁共振成像血管造影(postmortem magnetic resonance angiography,PMMRA)的可行性。方法纳米粒子γ-Fe2O3(30nm)通过油酸(oleic acid,OA)表面修饰后,均匀分散在石蜡油(paraffin oil,PO)中,制备γ-Fe2O3浓度为0~1000μg/ml的MNPF。MNPF导入试管密封后固定在MR仪扫描床上,使用T1w-SE、T2w-SE和3DT2*w-GR扫描序列获取影像数据并分析影像学特点。将γ-Fe2O3浓度为0μg/ml、25μg/ml和1000μg/ml的MNPF灌注至牛离体心脏冠脉中,使用T1wSE、T2w-SE扫描序列获取影像数据并分析影像学特点。结果当γ-Fe2O3浓度在0~100μg/ml范围时,MNPF在T1wSE影像上呈现高信号,在T2w-SE影像上呈现低信号,在T2*w-SE影像上,MNPF随着γ-Fe2O3浓度的增加信号逐渐降低直至消失。当γ-Fe2O3浓度超过100μg/ml时,将可能导致磁敏感伪影的产生,而不适合造影剂的使用。结论一定浓度范围的γ-Fe2O3脂溶性MNPF,有可能成为PMMRA的T1阳性造影剂和信号可控T2*对比剂。

关键词：尸体断层影像学尸体磁共振成像血管造影纳米磁流体 γ-Fe2O3 30nm

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