Imaging Ballistic Injuries

Abstract

<jats:p> Here in Canada, we often think of gun violence as confined to conflict zones, terrorism, and more of a problem for our southern neighbor. However, in recent years, it has also become a Canadian problem with increased gun violence related to criminal activity presenting in daily practice. Radiologists play a critical role in the evaluation of ballistic trauma and must therefore be familiar with both the common and uncommon patterns of ballistic injury. In this article, we review the mechanisms of ballistic trauma as well as their resultant injury patterns in order to guide image interpretation. </jats:p>

Transmediastinal penetrating trauma

“…Studies have demonstrated that in the absence of mediastinal injury or threatening trajectory on CT, the patient can be safely managed non-operatively and without further investigations of mediastinal organs ( 2 , 4 ). With missiles, trajectories are generally linear, but projectiles may fragment within the body or alter course when they deflect on bone or fascia ( 29 ). These may contribute to difficulty in evaluation of trajectory ( 4 ).…”

“…These may contribute to difficulty in evaluation of trajectory ( 4 ). Projectile embolization is another rare phenomenon observed in which the projectile breaches a vascular structure and travels to a distant location from its entry point ( 29 ).…”

The Precision, Inter-Rater Reliability, and Accuracy of a Handheld Scanner Equipped with a Light Detection and Ranging Sensor in Measuring Parts of the Body—A Preliminary Validation Study

“…A major difference between scanning protocols for living people and the present study is that since this method involves acquiring scans of a cadaver, any motion artifacts that may exist in the case of living people are inherently eliminated. Computed tomography (CT) is commonly employed in post-mortem investigations [ 23 , 24 , 25 , 26 ], and its use for forensic anthropological measurements has recently been tested [ 27 , 28 ]. Fourie et al evaluated the accuracy and reliability of standard anthropometric linear measurements on cadaver heads made by three different three-dimensional scanning systems (surface laser scanning (Minolta Vivid 900), cone beam computed tomography (CBCT), and 3D stereophotogrammetry (Di3D system)) and compared them with physical linear measurements, showing that measurements recorded by the three 3D systems appeared to be both sufficiently accurate and reliable enough for research and clinical use [ 18 ].…”