Correlations of Autopsy and Postmortem CT in Fatal Ballistic Injuries

Abstract

Purpose: To study the respective contributions and correlations of autopsy and PMCT in fatal ballistic injuries. Methods: A single-center retrospective descriptive study was carried out over a 10-years period (2008–2017) that included cases of fatal ballistic injuries that had undergone unenhanced PMCT followed by autopsy. In addition to demographics, the main data collected independently at autopsy and PMCT were the number of injuries, their trajectory, distances from the sole of the feet of the entry and exit wounds, projectile caliber and gunshot residue, detailed examination of the injuries, and detection of effusions. Results: Initially, 225 cases were included, of which 158 complete records were analyzed. The mean age of the victims was 41.5 years, and 93% were male. PMCT and autopsy findings were concordant concerning the number of injuries, their trajectory, and distance of the entry and exit wounds from the sole of the feet. Findings were not concordant regarding gunshot residues on the skin (autopsy more efficient) or detection of effusions (PMCT more efficient). The limitations of PMCT were the positioning of the limbs outside the field of acquisition and the impossibility of reliably determining the caliber of the projectiles. Some discrepancies were related to occasionally missing autopsy data, particularly the distance from the sole of the feet or measurements of the volume of effusion. Conclusions: This study provides more detailed knowledge of the accordance of autopsy and PMCT in analyzing fatal ballistic injuries.