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Synergy of CT and MRI in detecting trajectories of lodged bullets in decedents and potential hazards concerning the heating and movement of bullets during MRI


Gascho, Dominic; Tappero, Carlo; Zoelch, Niklaus; Deininger-Czermak, Eva; Richter, Henning; Thali, Michael J; Schaerli, Sarah (2020). Synergy of CT and MRI in detecting trajectories of lodged bullets in decedents and potential hazards concerning the heating and movement of bullets during MRI. Forensic Science, Medicine, and Pathology, 16(1):20-31.

Abstract

The purpose of this study was to assess the value of magnetic resonance imaging (MRI) in addition to computed tomography (CT) in gunshot wound cases with bullets or pellets lodged inside the head. In this context, the potential heating and movement of the lodged bullets were additionally investigated using animal models. Eleven forensic cases of penetrating gunshot wounds underwent CT and MRI. The data of each imaging modality were reviewed according to the following relevant characteristics: bony lesion at the entrance, intracranial bone fragments, intracranial metal fragments, gunshot residues, the wound channel and the severity of metal artifacts. Four-point Likert scales were used for the assessment. The heating of projectiles and their magnetic field interactions with the static magnetic field were assessed using animal models. MRI presented major advantages in cases with transversal trajectories and non-ferromagnetic bullets compared to CT. In general, MRI enabled a clear visualization of the wound channel and gunshot-related soft tissue injuries. An image fusion of CT and MRI datasets demonstrated the individual strengths of both modalities. Radio frequency (RF)-induced heating due to bullets lodged inside the brain tissue was invalidated. The likelihood of ferromagnetic projectile migration inside brain tissue is low. MRI of decedents with a bullet lodged inside their heads is viable and provides a valuable supplement to CT. The in situ, noninvasive depiction of the wound channel and gunshot-related soft tissue injuries on MRI can contribute to the knowledge of wound ballistics.

Abstract

The purpose of this study was to assess the value of magnetic resonance imaging (MRI) in addition to computed tomography (CT) in gunshot wound cases with bullets or pellets lodged inside the head. In this context, the potential heating and movement of the lodged bullets were additionally investigated using animal models. Eleven forensic cases of penetrating gunshot wounds underwent CT and MRI. The data of each imaging modality were reviewed according to the following relevant characteristics: bony lesion at the entrance, intracranial bone fragments, intracranial metal fragments, gunshot residues, the wound channel and the severity of metal artifacts. Four-point Likert scales were used for the assessment. The heating of projectiles and their magnetic field interactions with the static magnetic field were assessed using animal models. MRI presented major advantages in cases with transversal trajectories and non-ferromagnetic bullets compared to CT. In general, MRI enabled a clear visualization of the wound channel and gunshot-related soft tissue injuries. An image fusion of CT and MRI datasets demonstrated the individual strengths of both modalities. Radio frequency (RF)-induced heating due to bullets lodged inside the brain tissue was invalidated. The likelihood of ferromagnetic projectile migration inside brain tissue is low. MRI of decedents with a bullet lodged inside their heads is viable and provides a valuable supplement to CT. The in situ, noninvasive depiction of the wound channel and gunshot-related soft tissue injuries on MRI can contribute to the knowledge of wound ballistics.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:510 Mathematics
Scopus Subject Areas:Health Sciences > Pathology and Forensic Medicine
Uncontrolled Keywords:Pathology and Forensic Medicine, General Medicine
Language:English
Date:1 March 2020
Deposited On:16 Dec 2019 11:43
Last Modified:22 Apr 2020 21:42
Publisher:Springer
ISSN:1547-769X
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s12024-019-00199-y
PubMed ID:31768872

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