Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies

Abstract

The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified) and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified) were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, “A. Soft Tissues of Head and Musculoskeletal System” and “B. Organs and Organ Systems”, each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections.

Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies: Application to the Tyrolean Iceman

“…Murphy et al [16] have already described several calcifications in areas where arteries would normally be located, including both carotid arteries at the level of the sella turcica, the left carotid artery in the neck, the distal aorta and the right iliac artery. However, calcification without detectable wall structure of the vessel cannot account for the presence of the arteries following the definitions of the checklist [10]. Murphy et al [16] stated that the arteries themselves could not be identified because of mummification and distortion.…”

“…It should be mentioned that 8 out of these 17 anthropogenic mummies had higher total scores than the Iceman with a maximum score of 189 in the best-preserved mummy. However, these mummies were all carefully treated shortly after death, for example by means of intra-arterial injection of chemicals, such as arsenic and mercury [10,32]. The Egyptian mummy from the Old Kingdom was the oldest mummy with available CT data for this study.…”

“…All mummies were spontaneously mummified. The mummies were examined by whole-body CT (Mx8000 Dual, Philips, Best, The Netherlands) with a slice thickness of 1.3 mm and 120 kV in standard algorithm (data from the "Lithuanian Mummy Project", partially published in [10, 26 -28] Whole-body CT examinations were performed with a slice thickness of 1.25 mm and 120 kV in standard algorithm (data from the "Sicily Mummy Project", partially published in [10,29]). ▪ A collection of seventeen anthropogenically preserved mummies from the same crypt in Palermo that were also studied by CT as described above.…”

“…The recently developed "Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies" [10] was used for the assessment. The checklist contains 97 checkpoints and is divided into two main categories: "A.…”

“…In this study, a recently developed "Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies" [10] was applied to CT examinations of the Tyrolean Iceman. In the field of paleopathology, the need for standardization has been expressed for many years.…”