The Use of CT Scans in Estimating Age at Death by Examining the Extent of Ectocranial Suture Closure

We examined the utility of CT scans in the evaluation of degree of ectocranial suture closure. Five cranial points (left and right midcoronal positions, left and right midlambdoidal positions, and the lambda) were evaluated in 231 CT scans using a three‐point scoring system (open, partial closed, and closed). The slice increment and thickness varied between three groups of the scans. The results showed a good correlation between degree of suture closure and increasing age in each group. Young individuals (<40 years) and old individuals (>60 years) could be clearly distinguished from the middle‐aged individuals. ANOVA test revealed no difference between two groups of scans and between left and right sides (p > 0.05). Interobserver agreement was good, especially considering the score by sides. The results of this study create the base for developing a robust and simple method to estimate the age at death using CT scans.     

Is Differentiation of Frequently Encountered Foreign Bodies in Corpses Possible by Hounsfield Density Measurement?

Abstract:  The radiological determination of foreign objects in corpses can be difficult if they are fragmented or deformed. With multislice computed tomography, radiodensities—referred to as Hounsfield units (HU)—can be measured. We examined the possibility of differentiating 21 frequently occurring foreign bodies, such as metals, rocks, and different manmade materials by virtue of their HU values. Gold, steel, and brass showed mean HU values of 30671–30710 (upper measurable limit), mean HU values for steel, silver, copper, and limestone were 20346, 16949, 14033, and 2765, respectively. The group consisting of objects, such as aluminum, tarmac, car front-window glass, and other rocks, displayed mean HU values of 2329–2131 HU. The mean HU value of bottle glass and car side-window glass was 2088, whereas windowpane glass was 493. HU value determination may therefore help in preautopsy differentiation between case-relevant and irrelevant foreign bodies and thus be useful for autopsy planning and extraction of the objects in question.     

Forensic imaging of projectiles using cone-beam computed tomography

In patients with gunshot injuries, it is easy to detect a projectile within the body due to the high-density of the object, but artefacts make it difficult to obtain information about the deformation and the exact location of the projectile in surrounding tissues. Cone-beam computed tomography (CBCT) is a new radiological imaging modality that allows radio-opaque objects to be localised and assessed in three dimensions. The full potential of the use of CBCT in forensic medicine has not yet been explored.In this study, three different modern projectiles were fired into the heads of pig cadavers (n = 6) under standardised conditions. Tissue destruction and the location of the projectiles were analysed separately using CBCT and multi-slice computed tomography (MDCT).The projectiles had the same kinetic energy but showed considerable differences in deformation behaviour. Within the study groups, tissue destruction was reproducible. CBCT is less severely affected by metallic artefacts than MDCT. Therefore CBCT is superior in visualising bone destruction in the immediate vicinity of the projectile and projectile deformation, whereas MDCT allows soft tissue to be evaluated in more detail.CBCT is an improved diagnostic tool for the evaluation of gunshot injuries. In particular, it is superior to MDCT in detecting structural hard-tissue damage in the immediate vicinity of high-density metal projectiles and in identifying the precise location of a projectile in the body.     

Application of the Iscan method to two- and three-dimensional imaging of the sternal end of the right fourth rib

Age determination is a major field of interest in physical and forensic anthropology. Among the different methods based on macroscopic skeletal study, the Iscan method, which analyzes the sternal end of the right fourth rib, is one of the most reliable. We applied the Iscan method to two- and three-dimensional multislice computed tomography (MSCT) reconstructions of the sternal end of the right fourth rib on 39 ribs. The intra-observer variability on MSCT reconstructions was good (gamma coefficient equal to 0.86; value of the Krippendorff's alpha reliability equal to 0.79); inter-observer variability on MSCT reconstructions was also good (gamma coefficient ranging from 0.82 to 0.88; value of the Krippendorff's alpha reliability ranging from 0.78 to 0.86). We demonstrated excellent agreement between the results of analysis of bone samples and those of the two- and three-dimensional images, in particular regarding bone projections, morphology of the pit and of its rim. The accuracy of age estimation did not significantly differ between the Iscan method applied to dry bones and the same method applied to MSCT images. Determination of the Krippendorff's alpha reliability coefficient for the inter-error method confirmed the agreement between phase estimations obtained with the two methods (ranging from 0.55 to 0.71). The real civil age was comprised in 21 cases out of 36 for assessment performed on dry bones and in 23 cases out of 36 on MSCT reconstructions, which represented 58.3% and 63.9%, respectively. Use of MSCT reconstructions in forensic anthropology offers many advantages: no bone preparation, no damage to bone material, and the possibility of application to living individuals.     

Child abuse: practical application of autopsy, radiological, and microscopic studies

A 17-month-old male infant died at home. The infant's right arm was immobilized because of a humeral fracture 1 month earlier. The circumstances of death appeared unclear to the police investigators and a medicolegal autopsy was carried out. External examination revealed diffuse ecchymoses of varying color. Postmortem imaging was performed prior to autopsy (X-rays, multislice computed tomography [MSCT], and focused brain magnetic resonance imaging [MRI]). These investigations revealed four rib fractures of varying ages, one of which was posterior. Cerebral and pericerebral traumatic lesions were also diagnosed: bilateral subdural hematomas, intraventricular, meningeal, and interpedoncular hemorrhages. In the abdomen, fresh blood was visible within the anterior abdominal wall and the mesenteric root. Autopsy and microscopic study confirmed these lesions. This case report illustrates the valuable assistance rendered by MSCT and MRI to diagnose abuse when a child has died in unclear circumstances.     

会计电算化的深入发展对会计的影响

会计电算化的深入发展必定表现出它的先进性 ,使传统会计人员制度的质量、方式、机构等都发生改变 ,但也出现了风险和弊端 ,所以要加强会计电算化的内部控制 ,向各行业提供准确无误的会计信息。     

尸体断层影像学文献计量分析

尸体断层影像学(post-mortem cross-sectional imaging,PMCSI),也称虚拟解剖(virtopsy)或解剖画像(Ai),是法医学的革命性技术。较国际而言,我国PMCSI领域发展相对缓慢。进行系统的PMCSI文献计量分析研究,对于厘清国际PMCSI发展整体概貌和制定我国PMCSI发展战略方面,有着重要的现实意义。本文通过对2013-2019年PMCSI领域下27个专业术语不同组合进行在线文献搜索,并对文献的年份、作者、研究领域、发表杂志、作者单位、发表国家等系列指标进行了定性定量分析。分析结果表明世界PMCSI发展迅速:PMCSI已成为国际法医学的研究热点;瑞士、日本和英国PMCSI研究位居世界领先地位;尸体计算机断层扫描、尸体计算机断层扫描血管造影和尸体磁共振成像三个领域研究最为深入;PMCSI研究已得到相关学界的认同;法医日常检案中普及PMCSI是世界发展趋势。     

Radiological, forensic, and anthropological studies of a concrete block containing bones

Multidisciplinary forensic, anthropological, and radiological studies of bone fragments encased in a concrete block were carried out to determine whether or not the bones were human. Multislice computed tomography (MSCT) investigation was performed before the bones were removed from the concrete. MSCT study pinpointed the location of the bone fragments within the concrete block, which was helpful for their extraction and recovery, and identified most of their types and nature. Osteological study on dry bones provided more accurate identification of the bones and of their side. According to both methods, the human skeletal remains were compatible with those of a child, aged 8-13 years old, with a minimum height of 128 cm. Neither investigation identified sex or racial phenotype. Both studies identified the skeletal remains as consisting of two animal and five human bones. Furthermore, both methods revealed that the concrete completely encased bones, suggesting a secondary burial.     

Blood aspiration as a vital sign detected by postmortem computed tomography imaging

Blood aspiration is a significant forensic finding. In this study, we examined the value of postmortem computed tomography (CT) imaging in evaluating findings of blood aspiration. We selected 37 cases with autopsy evidence of blood in the lungs and/or in the airways previously submitted to total-body CT scanning. The CT-images were retrospectively analyzed. In one case with pulmonary blood aspiration, biopsy specimens were obtained under CT guide for histological examination. In six cases, CT detected pulmonary abnormalities suggestive of blood aspiration, not mentioned in the autopsy reports. CT reconstructions provided additional data about the distribution and extent of aspiration. In one needle-biopsied case, the pulmonary specimens showed blood in the alveoli. We suggest the use of CT imaging as a tool complementary to traditional techniques in cases of blood aspiration to avoid misdiagnosis, to guide the investigation of lung tissue, and to allow for more evidence-based inferences on the cause of death.     

Cone‐beam Computed Tomography for Analyzing Variations in Inferior Alveolar Canal Location in Adults in Relation to Age and Sex*

Abstract: Previous studies have indicated that the relative position of the inferior alveolar canal and its mental and mandibular foramina in adults vary with age and show sexual dimorphism. Conceivably, these purported differences could be of forensic value for determining identity of human remains. This study was designed to determine the influence of age and sex on the relative position of inferior alveolar canal and its foramina in cone‐beam computed tomography (CBCT) studies of adults. Existing CBCT studies of the maxillofacial region from dentate adult patients selected at random and ranging in age from 18 to 80 years (110 women and 55 men) were acquired, and the location of the inferior alveolar canal was assessed at three points: the mandibular foramen in axial view, the inferior alveolar canal in coronal view, and the mental foramen in coronal view. Measurements were also expressed for the mental foramen as the percentile position from the nearest superior bony crest to the inferior border; corresponding position of the mandibular foramen from the anterior to the posterior border of the mandibular ramus; and for the inferior alveolar canal at the level of first permanent molar from the nearest buccal bony surface to the lingual surface and from the superior alveolar crest to the inferior border. Regression analyses were performed on the variables with regard to the effects of age and sex. Most analyses resulted in no statistical significance (p < 0.05). A few of the sex‐specific traits demonstrated near‐statistically significant effects; however, these characterizations generally resulted in a 1% or less change per age decade. Overall, the results demonstrated that the relative location of the inferior alveolar canal and associated foramina in adults remain fairly constant without regard to age and sex.