Forensic application of postmortem diffusion-weighted and diffusion tensor MR imaging of the human brain in situ.

BACKGROUND AND PURPOSE: DWI and DTI of the brain have proved to be useful in many neurologic disorders and in traumatic brain injury. This prospective study aimed at the evaluation of the influence of the PMI and the cause of death on the ADC and FA for the application of DWI and DTI in forensic radiology. MATERIALS AND METHODS: DWI and DTI of the brain were performed in situ in 20 deceased subjects with mapping of the ADC and FA. Evaluation was performed in different ROIs, and the influence of PMI and cause of death was assessed. RESULTS: Postmortem ADC values of the brain were decreased by 49%-72% compared with healthy living controls. With increasing PMI, ADCs were significantly reduced when considering all ROIs together and, particularly, GM regions (all regions, P < .05; GM, P < .01), whereas there was no significant effect in WM. Concerning the cause of death, ADCs were significantly lower in mechanical and hypoxic brain injury than in brains from subjects having died from heart failure (traumatic brain injury, P < .005; hypoxia, P < .001). Postmortem FA was not significantly different from FA in living persons and showed no significant influence of PMI or cause of death. CONCLUSIONS: Performing postmortem DWI and DTI of the brain in situ can provide valuable information for application in forensic medicine. ADC could be used as an indicator of PMI and could help in the assessment of the cause of death.

Extended CT scale overcomes restoration caused streak artifacts for dental identification in CT--3D color encoded automatic discrimination of dental restorations.

OBJECTIVE: Besides DNA, dental radiographs play a major role in the identification of victims in mass casualties or in corpses with major postmortem alterations. Computed tomography (CT) is increasingly applied in forensic investigations and is used to scan the dentition of deceased persons within minutes. We investigated different restoration materials concerning their radiopacity in CT for dental identification purposes. METHODS: Extracted teeth with different filling materials (composite, amalgam, ceramic, temporary fillings) were CT scanned. Radiopacities of the filling materials were analyzed in extended CT scale images. RESULTS: Radiopacity values ranged from 6000-8500HU (temporary fillings), 4500-17000HU (composite fillings) and >30710HU (Amalgam and Gold). The values were used to define presets for a 3D colored volume rendering software. CONCLUSIONS: The effects of filling material caused streak artifacts could be distinctively reduced for the assessment of the dental status and a postprocessing algorithm was introduced that allows for 3D color encoded visualization and discrimination of different dental restorations based on postmortem CT data.

Line-scan diffusion tensor imaging of the posttraumatic brain stem: changes with neuropathologic correlation.

Following trauma, imaging of brain stem lesions is often inconclusive. In a man who suffered a lethal accident, postmortem MR diffusion tensor (DT) imaging of the brain and neuropathologic examination were performed. DT imaging showed a disorganization of fibers in the brain stem that was not found in 2 controls and corresponded to changes on neuropathologic correlation. Diffusion tensor imaging provides an insight into the organization of myelinated structures of the CNS, potentially allowing diagnosis of traumatic fiber tract rupture.

Maximum intensity projection of cranial computed tomography data for dental identification.

Dental radiographs play the major role in the identification of victims in mass casualties besides DNA. Under circumstances such as those caused by the recent tsunami in Asia, it is nearly impossible to document the entire dentition using conventional x-rays as it would be too time consuming. Multislice computed tomography can be used to scan the dentition of a deceased within minutes, and the postprocessing software allows visualization of the data adapted to every possible antemortem x-ray for identification. We introduce the maximum intensity projection of cranial computed tomography data for the purpose of dental identification exemplarily in a case of a burned corpse. As transportable CT scanners already exist, these could be used to support the disaster victim identification teams in the field.

Postmortem imaging of blood and its characteristics using MSCT and MRI.

The rapid development of computed tomography (CT) and magnetic resonance imaging (MRI) led to the introduction and establishment in postmortem investigations. The objectives of this preliminary study were to describe the imaging appearances of the early postmortem changes of blood after cessation of the circulation, such as sedimentation, postmortem clotting, and internal livores, and to give a few first suggestions on how to differentiate them from other forensic findings. In the Virtopsy project, 95 human corpses underwent postmortem imaging by CT and MRI prior to traditional autopsy and therefore 44 cases have been investigated in this study. Postmortem alterations as well as the forensic relevant findings of the blood, such as internal or subcutaneous bleedings, are presented on the basis of their imaging appearances in multislice CT and MRI.

Fatal scuba diving incident with massive gas embolism in cerebral and spinal arteries.

CT and MRI have the potential to become useful adjuncts to forensic autopsy in the near future. The examination of fatal injuries facilitates a profound experience in the clinical-radiological examination of these cases; the more severe findings in corpses with autopsy verification can help one to understand the tiny signs seen in clinical cases of surviving victims. We present the case of a 44-year-old male diver who died from severe decompression sickness after rapid ascent from approximately 120 m. Post-mortem CT and MRI studies of the brain and spinal cord revealed extensive gas inclusions in cerebral arteries, spinal arteries and cerebrospinal fluid (CSF) spaces, while the intracranial venous sinuses remained unaffected. These findings were confirmed at autopsy. Appropriate imaging techniques can help forensic pathologists to aim their autopsies at findings that might otherwise remain undetected.

Is 'virtual histology' the next step after the 'virtual autopsy'? Magnetic resonance microscopy in forensic medicine.

AIM: The study aimed to validate magnetic resonance microscopy (MRM) studies of forensic tissue specimens (skin samples with electric injury patterns) against the results from routine histology. METHODS AND RESULTS: Computed tomography and magnetic resonance imaging are fast becoming important tools in clinical and forensic pathology. This study is the first forensic application of MRM to the analysis of electric injury patterns in human skin. Three-dimensional high-resolution MRM images of fixed skin specimens provided a complete 3D view of the damaged tissues at the site of an electric injury as well as in neighboring tissues, consistent with histologic findings. The image intensity of the dermal layer in T2-weighted MRM images was reduced in the central zone due to carbonization or coagulation necrosis and increased in the intermediate zone because of dermal edema. A subjacent blood vessel with an intravascular occlusion supports the hypothesis that current traveled through the vascular system before arcing to ground. CONCLUSION: High-resolution imaging offers a noninvasive alternative to conventional histology in forensic wound analysis and can be used to perform 3D virtual histology.

Bite mark documentation and analysis: the forensic 3D/CAD supported photogrammetry approach.

Bite mark identification is based on the individuality of a dentition, which is used to match a bite mark to a suspected perpetrator. This matching is based on a tooth-by-tooth and arch-to-arch comparison utilising parameters of size, shape and alignment. The most common method used to analyse bite mark are carried out in 2D space. That means that the 3D information is preserved only two dimensionally with distortions. This paper presents a new 3D documentation, analysis and visualisation approach based on forensic 3D/CAD supported photogrammetry (FPHG) and the use of a 3D surface scanner. Our photogrammetric approach and the used visualisation method is, to the best to our knowledge, the first 3D approach for bite mark analysis in an actual case. The documentation has no distortion artifacts as can be found with standard photography. All the data are documented with a metric 3D measurement, orientation and subsequent analysis in 3D space. Beside the metrical analysis between bite mark and cast, it is possible using our method to utilise the topographical 3D feature of each individual tooth. This means that the 3D features of the biting surfaces and edges of each teeth are respected which is--as shown in our case--very important especially in the front teeth which have the first contact to the skin. Based upon the 3D detailed representation of the cast with the 3D topographic characteristics of the teeth, the interaction with the 3D documented skin can be visualised and analysed on the computer screen.

Into the decomposed body-forensic digital autopsy using multislice-computed tomography.

It is impossible to obtain a representative anatomical documentation of an entire body using classical X-ray methods, they subsume three-dimensional bodies into a two-dimensional level. We used the novel multislice-computed tomography (MSCT) technique in order to evaluate a case of homicide with putrefaction of the corpse before performing a classical forensic autopsy. This non-invasive method showed gaseous distension of the decomposing organs and tissues in detail as well as a complex fracture of the calvarium. MSCT also proved useful in screening for foreign matter in decomposing bodies, and full-body scanning took only a few minutes. In conclusion, we believe postmortem MSCT imaging is an excellent vizualisation tool with great potential for forensic documentation and evaluation of decomposed bodies.

A high-speed study of the dynamic bullet-body interactions produced by grazing gunshots with full metal jacketed and lead projectiles.

Experimenting upon a synthetic, non-biological Skull-Brain Model, our goal was to document and study the bullet-body interaction of grazing (glancing, tangential) gunshots. Thanks to the high-speed study of the dynamic bullet-body interaction it was possible to document the glancing behavior of projectiles with a resolution of 50 million pictures per second. It was possible to demonstrate the differing deformation and fragmentation patterns between the 9mm Luger full metal jacketed projectile and the 38 Smith & Wesson (S & W) lead round nose projectile. In a true-to-life manner the morphologic fracture systems could be documented by utilization of the model in dependence of the projectile's behavior, deformation, and fragmentation. Based on these experimental studies with body models, conclusions could be drawn for surgical and reconstructive forensic questions in real cases. In summary, model substitutes offer a suitable basis for the study of the bullet-body interaction because the experiments are reproducible, totally independent of the biological variances of corpse and animal experiments, and are harmless from the ethical perspective.

Analysis of patterned injuries and injury-causing instruments with forensic 3D/CAD supported photogrammetry (FPHG): an instruction manual for the documentation process.

Forensic 3D/CAD supported photogrammetry (FPHG) is a method of recording and documenting the surface of small objects, thus enabling a three-dimensional image of these objects in virtual space. With this representation on the computer screen the course of forensically relevant events can be reconstructed. The procedure allows for examining patterned injuries of skin, soft tissue or bones for matching potentially incriminated instruments in shape, size and angle.3D recording of objects to be examined requires taking series of photographs. A computer system then calculates the position in space of certain points on the surface of the objects and subsequently produces 3D data models of the objects. Using a 3D/CAD program these data models are used to generate graphic true-to-object volume models. The objects in question can then be moved against each other arbitrarily on the screen-depending on the questions to be answered-in order to compare them and possibly establish their congruence. This article covers the state of the art in FPHG procedures in the form of a step-by-step instruction. It also illustrates the wide range of FPHG applications.

The dynamic development of the muzzle imprint by contact gunshot: high-speed documentation utilizing the "skin-skull-brain model".

Many contact gunshots produce a muzzle imprint in the skin of the victim. Different mechanisms have been discussed in literature as being responsible for the creation of the muzzle imprint. Experimenting upon the synthetic non biological skin-skull-brain model, our goal was to document and study the creation of the muzzle imprint with the aid of high-speed photography. In our experiments, we could document with our high-speed photography (at exposure rates in the range of nanoseconds) the bulging, the pressing against the muzzle, and the splitting of the artificial skin. Furthermore, it was possible to photographically record the back pattern of synthetic tissue particles. And, the soot and gunpowder cavity could be reproduced experimentally. In conclusion the experiments completed with the skin-skull-brain model, using high-speed photography for documentation, show the promising possibilities of experimental ballistics with body models.

The "skin-skull-brain model": a new instrument for the study of gunshot effects.

In order to create and study wound morphology, a "skin-skull-brain model" had to be designed which would make the laboratory reproduction of a real ballistic injury possible. To simulate the human skin, an artificial skin (a silicon cap) is used. This silicon scalp contains synthetic fibers (artificial leather) to simulate the collagen and fat of the scalp. The artificial skull is a layered polyurethane sphere (19 cm o.d.; and 5, 6, or 7 mm thick) constructed in a specially designed form with a Tabula externa, Tabula interna, and a porous Diploe sandwiched in between. The periostium of the artificial skull is made of latex. This elastic latex layer prevents the bone fragments from scattering after the model has been struck by gunfire. The brain itself is simulated with ordnance gelatin, 10% at 4 degrees C, a material well known in wound ballistics. Gunshots were fired at a distance of 10 m from the model. During the evaluation of the "skin-skull-brain model", it was possible to show that injuries inflicted to this model are fully comparable to the morphology of equivalent real gunshot injuries. Using the "skin-skull-brain model" has some significant advantages: the model is inexpensive, easy to construct, instantly available for use, and eliminates ethics conflicts. The main advantage of such a model is, in comparison with biological substances, the high reproducibility of inflicted traumas.

A study of the morphology of gunshot entrance wounds, in connection with their dynamic creation, utilizing the "skin-skull-brain model".

The goal of this study was to document the dynamic effects created within, and the developing mechanisms of a gunshot entrance wound to the skin utilizing high-speed photography and the "skin-skull-brain model". The high-speed photography was taken with an Imacon 468/Hadland-Photonics camera. Full metal jacketed, 9 mm Luger projectiles were fired at the target model from a distance of 10 m. During the evaluation of the "skin-skull-brain model", it was possible to show that injuries inflicted to this model are fully comparable to the morphology of equivalent real gunshot entrance wounds. It has been possible to document and study the dynamic process of the "bullet-skin-interaction" in the gunshot entrance wound. The development of the morphologic terms of the entrance wound are discussed. In combination with high-speed photography, this "skin-skull-brain model" is a perfect tool for the documentation and the study of the dynamic development of gunshot entrance wounds in the skin.

Body models in forensic ballistics: reconstruction of a gunshot injury to the chest by bullet fragmentation after shooting through a finger.

Forensic science uses substitutes to reconstruct injury patterns in order to answer questions regarding the dynamic formation of unusual injuries. Using a case study, an experimental simulation of a finger was designed, for the first time with a combination of hard wood and glycerin soap. With this model as an intermediate target simulation, it was possible not only to demonstrate the "bullet-body (finger) interaction", but also to recreate the wound pattern found in the victim. This case demonstrates that by using ballistic models and body-part substitutes, gunshot cases can be reproduced simply and economically, without coming into conflict with ethical guidelines.

Fluorescence polarization immunoassay for the detection of drugs of abuse in human whole blood.

Fluorescence polarization immunoassay (FPIA) is a technique which has been known for a number of years. Since the development of the fundamental principles of fluorescence polarization by Perrin in a series of papers beginning in 1926, immunological techniques using labelled reactants have gained an extraordinary importance in the field of medical research and in routine diagnosis. As one of the non-radioactive immunological techniques, FPIA has found broad application in clinical and forensic toxicology. The authors report a new method to quickly screen autopsy, police and hospital blood samples for opiates, benzodiazepines, benzoylecgonine, barbiturates and methadone after Extrelut extraction utilising the FPIA methodology.

Matching tire tracks on the head using forensic photogrammetry.

In the field of the documentation of forensics-relevant injuries, from the reconstructive point of view, the forensic, CAD-supported photogrammetry plays an important role; particularly so when a detailed 3-D reconstruction is vital. This is demonstrated with a soft-tissue injury to the face caused by being run over by a car tire. Since the objects (injury and surface of the tire) to be investigated will be evaluated in virtual space, they must be series photographed. These photo sequences are then evaluated with the RolleiMetric multi-image evaluation system. This system measures and calculates the spatial location of points shown in the photo sequences, and creates 3-D data models of the objects. In a 3-D CAD program, the model of the injury is then compared against the model of the possible injury-causing instrument. The validation of the forensic, CAD-supported photogrammetry, as shown by the perfect 3-D match between the tire tread and the facial injury, demonstrates how greatly this 3-D method surpasses the classic 2-D overlay method (one-to-one photography).

Diatom detection in the diagnosis of death by drowning.

A medicolegal/algological collaboration lasting several years aimed at developing methods for dealing with dead bodies found in water where the circumstances are not clear, has led to an interdisciplinary procedure. To enable algological analysis, sample preservation and preparation must be free from contamination or carry-over at the beginning of the autopsy, although it should be noted that the demands on the digestion method are very high. One or more water samples from the site of drowning (from surface and bed) should be taken. Microscopic-algological analysis should record quantitative (diatom density), qualitative (species) and morphological (description of diatom valves) details for every sample. Furthermore, the species index and dominance identity similarity indices are calculated during the analysis procedure. The algological conclusions are based primarily on the separation values of Kater as well as on pair-matching. The final report is the result of interdisciplinary collaboration.

Swiss Caucasian population data for 13 STR loci using AmpFISTR profiler plus and cofiler PCR amplification kits.

Allele and genotype frequencies for the 13 core STR loci (D3S1358, VWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820, THO1, TPOX, CSF1PO, and D16S539) were determined in a Swiss Caucasian population sample (n = 206) using two commercially available multiplex PCR kits (AmpFISTR Profiler Plus and AmpFISTR Cofiler) and subsequent electrophoresis on an ABI PRISM CE 310 Genetic Analyzer instrument. All loci meet Hardy-Weinberg expectations. In addition, there is little evidence for association of alleles among the 13 loci. The allelic frequency data can be used in forensic analyses and paternity tests to estimate the frequency of a multiple STR locus DNA profile in the Swiss population.

Evaluation of prostate-specific antigen (PSA) membrane test assays for the forensic identification of seminal fluid.

Prostate specific antigen (PSA, also known as p30), a glycoprotein produced by the prostatic gland and secreted into seminal plasma, is a marker used for demonstrating the presence of seminal fluid. Methods for the detection of PSA include Ouchterlony double diffusion, crossover electrophoresis, rocket immuno-electrophoresis, radial immunodiffusion, and ELISA. The extremely sensitive ELISA technique can detect PSA in concentrations as low as approximately 4 ng/mL. However, all these techniques are cumbersome and time consuming to perform in forensic laboratories, especially when only a few samples per week are processed. Various membrane tests are currently used in clinical settings to screen a patient's serum for the presence of PSA at levels greater than 4 ng/mL. In this study we evaluated three immunochromatographic PSA membrane tests by analyzing semen stains stored at room temperature for up to 30 years, post-coital vaginal swabs taken at different time after intercourse, semen-free vaginal swabs, and various female and male body fluids, including urine. The data demonstrate that PSA membrane test assays offer the same sensitivity as ELISA-based tests and provide a rapid approach for the forensic identification of seminal fluid. Furthermore, when the supernatant from a DNA extraction is used for the assay, there is essentially no DNA consumption for determining the presence of PSA in a forensic sample.