Department of Pathology (Forensic Medicine) University of Edinburgh
En esta ocasión presentamos un artículo en el que el autor destaca la importancia que están tomando las técnicas de estudio por imagen, como la Resonancia Magnética Nuclear y la Tomografía Axial Computerizada en el campo de la patología forense, ya que en muchas ocasiones se deben de llevar a cabo estas exploraciones para así obtener determinadas pruebas que nos puedan conducir a la causa de la muerte y que una vez abierto el cadáver se perderían (heridas por arma blanca, proyectiles, neumotórax, trayectorias, fracturas óseas múltiples…).
Este artículo aparece en una nueva revista on line en el que todos sus artículos son de libre disposición, lo que conocemos como Open Access y que estará disponible en internet mensualmente. En el sumario de este primer número destacan, aparte del artículo que presentamos en amplia-mente, estos otros estudios:
– Quantitative Analysis of 30 Drugs in Whole Blood by SPE and UHPLC-TOF-MSPDF.
– Toxicological Screening and Quantitation Using Liquid Chromatography/Time-of-Flight Mass Spectrometry.
– The Infanticide: Some Forensic and Ethical Issues.
Post-mortem imaging in the form of plain X-ray films has been in use for many years as an adjunct or occasionally as a substitute for autopsy. However, in the last two decades there has been increasing interest and investigation into the use of advanced techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in death investigation.
Post-mortem CT imaging has several advantages over autopsy alone, since it produces high resolution detailed images of the body including areas that may not be easily accessible to the prosector, and allows documentation of abnormalities and injuries without the tissue disruption necessitated by the autopsy. In addition, the image orientation (planes) and relative contrast of different tissues can be manipulated to better visualize different types of pathology. Three dimensional (3D) image construction is also possible with the appropriate software. Several recent studies have compared the use of post mortem imaging with autopsy in injury evaluation. There was variable agreement between autopsy and CT findings, and CT was able to detect many injuries that were not found at autopsy. One study showed that post mortem CT was more sensitive for detection of skeletal and head and neck region injuries compared with autopsy. In this study, the authors used the Abbreviated Injury Scale, an anatomical-based coding system, to classify injuries in a standardized way and permit objective comparison between CT and autopsy. CT is also valuable in the documentation of gunshot wounds, not least because it allows three dimensional visualization of the wound course, as well as detection of subtle fractures and small bullet fragments that may be difficult to find at autopsy. MRI and CT imaging has also been used in the investigation of child deaths, and CT is more sensitive for detection of rib fractures than conventional X-ray. However, this is a relatively new use of the modality. One study involving 47 cases of sudden unexpected child deaths found a general concordance between autopsy and post mortem CT findings, except in a few cases of pneumonia.
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