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Child Abuse: Practical Application of Autopsy, Radiological, and Microscopic Studies

NCJ Number
225609
Journal
Journal of Forensic Sciences Volume: 53 Issue: 6 Dated: November 2008 Pages: 1424-1429
Author(s)
Fabrice Dedouit M.D.; Celine Guilbeau-Frugier M.D.; Caroline Capuani M.S.; Annick Sevely M.D.; Francis Joffre M.D., Ph.D.; Daniel Rouge M.D., Ph.D.; Herve Rousseau M.D., Ph.D.; Norbert Telmon M.D., Ph.D.
Date Published
November 2008
Length
6 pages
Annotation
This case report illustrates the valuable contribution of multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in diagnosing abuse of a child who died under unclear circumstances.
Abstract
In the case reported, postmortem imaging was performed prior to autopsy, using X-rays, MSCT, and focused brain MRI. These investigations revealed four rib fractures of varying ages, one of which was posterior. Cerebral and pericerebral traumatic lesions were also diagnosed. These included bilateral subdural hematomas and intraventricular, meningeal, and interpedoncular hemorrhages. In the abdomen, fresh blood was visible within the anterior abdominal wall and the mesenteric root. Autopsy and microscopic study confirmed these lesions. The authors conclude that although postmortem imaging alone is not sufficient to determine cause of death under unclear circumstances, it is valuable when used in combination with information from medical history, clinical course before death, laboratory findings, and bacterial culture. The postmortem full-body MSCT investigation was performed on the day of death. Axial MSCT was performed with 16 x 0.75 mm collimation on a Sensation 16 unit. Two-dimensional and three-dimensional reconstructions were obtained on a Leonardo workstation. Two-dimensional reconstructions were obtained using multiplanar reconstruction. Three-dimensional reconstructions were obtained using volume rendering technique and maximum intensity projection modes. Focused cerebral MRI was also performed on the day of death. Postmortem full-body radiological study was performed in the medical department. X-rays of the skull, thorax, abdomen, pelvis, and the upper and lower limbs were obtained. 5 figures and 15 references