Postmortem Computed Tomography and Magnetic Resonance Imaging of Gunshot Wounds to the Neck

Abstract

Postmortem magnetic resonance imaging (MRI) is rarely used for the radiologic assessment of gunshot injuries, although it has clear advantages over postmortem computed tomography (CT) with regard to the imaging of soft tissue injuries. Another benefit in using MRI is that lodged projectiles composed of nonferromagnetic material such as lead present only marginal metal artifacts compared with severe artifacts on CT. This case report presents CT and MRI findings in a case with two gunshot wounds to the neck: a perforating wound and a nonperforating wound with a lead bullet lodged in the cervical spine. The decedent underwent CT and MRI before the scheduled autopsy. A ring of radiopaque material under the dermis in the fatty tissue was identified at both entrance wounds on CT, which was indicative of contact shots. The perforating gunshot was clearly indicated on CT by bullet fragments along the wound channel through the perforated 6th cervical vertebra and the fractured cricoid cartilage at the exit wound. The second trajectory, however, was only assumed based on the presence of gunshot residues at the entrance wound and the position of the lodged bullet. The radiologic assessment was severely impeded by the metal artifacts on CT. Barely noticeable metal artifacts on MRI allowed for clear visualization of the soft tissue injuries and the ruptured medulla oblongata. Only MRI clarified the soft tissue injuries of the brainstem noninvasively, which could provide specific and graphic information on the rapidity of death and the incapacitation of the victim.

Interpol review of forensic firearm examination 2019–2022

“…The benefits of using MRI over the more commonly used CT in Postmortem Computed Tomography are discussed and illustrated by a case in which a victim had received two gunshot wounds to the neck [ 146 ]. One bullet had exited, while the other (lead .22 Long Rifle) bullet had lodged itself in the cervical spine.…”

Loss of Uncoupling Protein 1 Expression in the Subcutaneous Adipose Tissue Predicts Childhood Obesity

“…Fetal UCP1 + adipocytes were analyzed from adipose tissue specimens collected during autopsy of fetal death cases (Supplemental Table S1). Postmortem computed tomography (CT) scanning was performed on a museum specimen of an in utero male fetus [62]. Postnatal UCP1 + adipocytes were analyzed from adipose tissue specimens of 107 patients (male 79, female 28) of 0.2-17.3 years of age collected during elective surgery.…”

Forensic Imaging: A Powerful Tool in Modern Forensic Investigation

“…In 2020, Gascho et al. [ 74 ] emphasized the importance of MRI in gunshot case investigation. In one of the shooting investigations, MRI clearly showed the soft tissue injuries and the ruptured medulla oblongata, providing the investigators the graphic information on the death.…”

“…In forensic ballistic, forensic imaging shows its limitation in reacting to the metal foreign objects. For example, due to the metal artifacts caused by residual bullets, the radiological assessment of gunshot wounds on CT may be severely impeded [ 74 ]. In forensic anthropology and odontology, imaging is often used to assist in age estimation or human identification.…”