Differentiation of Antemortem and Postmortem Appendicular Fractures Using Magnetic Resonance Imaging Signal Intensity Changes in Bone and Soft Tissues,

Intraosseous T1-weighted (T1W) and short-tau inversion recovery (STIR) magnetic resonance imaging (MRI) signal intensity changes—so-called bone marrow edema—may be able to differentiate antemortem and postmortem fractures in human forensic imaging. The primary objective of this study was to investigate this hypothesis using an animal model. Three juvenile Landrace pigs were anesthetized and underwent MRI of both tibiae and both radii using a 1.5 T magnet. T1W, T2-weighted (T2W), STIR, and T2* sequences were included. Antemortem fractures were induced in both tibiae and postmortem fractures in both radii, and MRI was repeated. Two board-certified radiologists blinded to fracture group jointly evaluated the images for intraosseous and soft tissue signal intensity changes. Sensitivity (Se) and specificity (Sp) in identifying antemortem fractures were calculated based on intraosseous, soft tissue, and combined intraosseous and soft tissue signal intensity changes. Intraosseous and soft tissue signal intensity changes, when present, were hyperintense in all sequences. Intraosseous hyperintensity in T1W and T2W sequences yielded Sp of 100% for antemortem fractures. Regardless of sequence, soft tissue hyperintensity was comparatively more sensitive than intraosseous hyperintensity. Sensitivity for each sequence could be maximized by assessment of soft tissue and intraosseous hyperintense signals together; for the T1W sequence, such assessment optimized diagnostic utility yielding a Se of 100% and Sp of 83%. In summary, MRI—particularly the T1W sequence—can differentiate antemortem and postmortem fractures and may be a useful adjunct to the forensic analyses of fractures.     

Identifying Fatal Head Injuries on Postmortem Computed Tomography Using Convolutional Neural Network/Deep Learning: A Feasibility Study

Postmortem computed tomography (PMCT) is a relatively recent advancement in forensic pathology practice that has been increasingly used as an ancillary investigation and screening tool. One area of clinical CT imaging that has garnered a lot of research interest recently is the area of “artificial intelligence” (AI), such as in screening and computer-assisted diagnostics. This feasibility study investigated the application of convolutional neural network, a form of deep learning AI, to PMCT head imaging in differentiating fatal head injury from controls. PMCT images of a transverse section of the head at the level of the frontal sinus from 25 cases of fatal head injury were combined with 25 nonhead-injury controls and divided into training and testing datasets. A convolutional neural network was constructed using Keras and was trained against the training data before being assessed against the testing dataset. The results of this study demonstrated an accuracy of between 70% and 92.5%, with difficulties in recognizing subarachnoid hemorrhage and in distinguishing congested vessels and prominent falx from head injury. These results are promising for potential applications as a screening tool or in computer-assisted diagnostics in the future.     

36例脑血管畸形猝死案例及法医病理学分析

目的探讨脑血管畸形猝死的法医病理学特点和检查方法。方法对1997年至2006年10月四川华西鉴定中心所做36例脑血管畸形猝死病例进行分析。结果脑血管畸形猝死以10~49岁男性为主,有25例(69.44%)。18例(50%)发病前有明显诱因。18例(50%)在发病后1h内迅速死亡。脑血管畸形猝死的病理类型以脑动静脉畸形最为常见,有33例(91.67%)。24例(66.67%)发生于脑底部、桥脑和小脑。破裂出血是脑血管畸形猝死的直接死因,出血类型以蛛网膜下腔出血最为常见,有22例(61.11%)。脑血管畸形部位和形态复杂多变,常规检查方法不能满足鉴定的需要。结论脑血管畸形猝死的鉴定百分之百准确比较困难,熟悉其法医病理学特点,掌握多种检查方法,才能做出客观、全面、准确的鉴定结论。     

家兔死后眼玻璃体液镁，铁含量与PMI关系的研究

目的寻找一种精确推定PMI的方法。方法应用电感耦合等离子体质谱(ICP-MS),检测家兔死后96h内眼玻璃体液镁、铁元素含量,探讨其与PMI的相关性。结果家兔死后0～48h眼玻璃体液镁元素含量与PMI显著相关,6～48h铁元素含量与PMI显著相关,其二项式回归方程分别为y=0.0738x2+0.6997x+11.45(R2=0.9119)、y=0.0411x2-0.3148x+1.4113(R2=0.9594)。结论家兔死后眼玻璃体液Mg、Fe含量变化可作为推定48h内PMI的参考指标之一。     

棕尾别麻蝇的季节分布及虫态变化与死亡时间的研究

目的提供法医学死亡时间鉴定的准确性.方法在海拔1115.2～¨20.8m处每月投放一次诱饵,一天观察两次并详细记录,对嗜尸蝇类季节分布进行1年的调查研究.发现棕尾别麻蝇只在8、9、10三个月份繁殖后代而且虫态变化历期也出现明显差异.特别是10月份幼虫进入蛹期后发育历期持续到次年4月份才羽化出蝇,整个发育历期长达半年之久.结果这种有季节性分布的蝇类及特定季节发育历期延长的特点,对法医学推断死亡时间及对其它嗜尸蝇类的研究均有参考价值.     

Oral abuse of fentanyl patches (Duragesic): seven case reports

In order to increase the understanding regarding the oral abuse and potential toxicity of fentanyl patches seven cases were identified over a 3-year period where fentanyl, either alone or in combination with other factors, contributed to death following the oral abuse of Duragesic patches. The decedents comprised three females and four males with ages ranging from 20 to 51 years. Postmortem blood fentanyl concentrations were determined in all cases and ranged from 7 to 97 ng/mL. Two deaths were classified as a fentanyl overdose, three deaths were classified as a fentanyl and ethanol overdose, one death was considered a mixed drug intoxication and the remaining death was determined to be a combination of fentanyl and medical causes. These cases represent the largest reported series of deaths following the oral administration of transdermal fentanyl patches and provide detailed information on the potential for the abuse of transdermal Duragesic patches via this route. The postmortem blood fentanyl concentrations detected for each of the decedents demonstrate the potentially fatal blood concentrations that can arise after this relatively rare route of administration.     

Perimortem or Postmortem Bone Fractures? An Experimental Study of Fracture Patterns in Deer Femora*

The determination of perimortem trauma is important for forensic anthropologists. Characteristics of bone fractures such as sharp edges, presence of fracture lines, the shape of the broken ends, fracture surface morphology, fracture angle on the Z-axis, and butterfly fractures are said to differentiate perimortem from postmortem trauma. A Drop Weight Impact Test Machine was used to break 76 deer femora of various ages since death. The results of this study suggest that the characteristics listed above are unreliable at differentiating a perimortem fracture from a postmortem fracture in a forensic case. There are, however, statistically significant differences between fresh bones broken less than 4 days old and dry bones broken 44 days or 1 year old after death.     

Facial soft tissue depths in craniofacial identification (part II): An analytical review of the published sub-adult data

Prior research indicates that while statistically significant differences exist between subcategories of the adult soft tissue depth data, magnitudes of difference are small and possess little practical meaning when measurement errors and variations between measurement methods are considered. These findings raise questions as to what variables may or may not hold meaning for the sub-adult data. Of primary interest is the effect of age, as these differences have the potential to surpass the magnitude of measurement error. Data from the five studies in the literature on sub-adults which describe values for single integer age groups were pooled and differences across the ages examined. From 1 to 18 years, most soft tissue depth measurements increased by less than 3 mm. These results suggest that dividing the data for children into more than two age groups is unlikely to hold many advantages. Data were therefore split into two groups with the division point corresponding to the mid-point of the observed trends and main data density (0-11 and 12-18 years; division point = 11.5 years). Published sub-adult data for seven further studies which reported broader age groups were pooled with the data above to produce the final tallied soft tissue depth tables. These tables hold the advantages of increased sample sizes (pogonion has greater than 1770 individuals for either age group) and increased levels of certainty (as random and opposing systematic errors specific to each independent study should average out when the data are combined).     

Generalized additive models and Lucilia sericata growth: assessing confidence intervals and error rates in forensic entomology

Forensic entomologists use blow fly development to estimate a postmortem interval. Although accurate, fly age estimates can be imprecise for older developmental stages and no standard means of assigning confidence intervals exists. Presented here is a method for modeling growth of the forensically important blow fly Lucilia sericata, using generalized additive models (GAMs). Eighteen GAMs were created to predict the extent of juvenile fly development, encompassing developmental stage, length, weight, strain, and temperature data, collected from 2559 individuals. All measures were informative, explaining up to 92.6% of the deviance in the data, though strain and temperature exerted negligible influences. Predictions made with an independent data set allowed for a subsequent examination of error. Estimates using length and developmental stage were within 5% of true development percent during the feeding portion of the larval life cycle, while predictions for postfeeding third instars were less precise, but within expected error.     

尸源性昆虫的法医学研究进展

尸源性昆虫学是应用昆虫学知识解决有关法律问题的法医学分支学科,对死亡时间的推断。特别是腐败尸体的死后间隔时间的推断等方面具有无可比拟的优越性。本文根据国内外近期法医昆虫学方面的研究进展,阐述了尸源性昆虫的研究历史、种类和侵蚀过程,并总结了尸源性昆虫形态学及分子生物学的种属鉴定方法。及近几年来在推断死亡时间方面的具体应用。就尸源性昆虫在法医学领域内的应用及进展进行综述。