title: Postmortem computed tomography (PMCT) and autopsy in deadly gunshot wounds--a comparative study.
abstract: BACKGROUND
  Postmortem computed tomography (PMCT) data in gunshot-related death were evaluated by two reader groups and compared to the gold standard autopsy for the determination of forensic pathology criteria.
  
  
  METHODS
  Reader group I consisted of two board-certified radiologists whereas one board-certified radiologist and one board-certified forensic pathologist formed group II. PMCT data of 51 gunshot-related deaths were evaluated for the forensic pathology criteria number of gun shots, localization of gunshot injury, caliber, and direction of the gunshot differentiating between entry and exit wound as well as associated injury to surrounding tissue. The results of both reader groups were compared to the each other and to autopsy findings considered as gold standard.
  
  
  RESULTS
  Reader groups I and II and as gold standard the autopsy evaluation showed in general a good correlation between all results. The overall discrepancy rate was 12/51 (23.4%) cases for group I and 8/51 (15.6%) for group II.
  
  
  CONCLUSIONS
  Ultimately, the designated reader is able to draw the following conclusion from the presented data. At first, physical autopsy is better than PMCT regarding the localization of most gunshot injuries. Second, PMCT presents with better results than physical autopsy in locating fragmented bullets/fragment clouds, and finally, PMCT results of two radiologists were equivalent to the results of one evaluating radiologist and one pathologist with the exception of caliber assessment. However, referring to the pure numbers, the slight but not significant difference in the overall discrepancy rate of both reader groups might indicate the advantage of combining expertise in evaluating imaging in cases of gunshot-related death.
authors.affiliation: Institute of Clinical Radiology, Klinikum Innenstadt, Ludwig Maximilians University Munich, Nussbaumstrasse 20, 80336, Munich, Germany. sonja.kirchhoff@med.uni-muenchen.de.
authors.forename: S M
authors.initials: SM
authors.lastname: Kirchhoff
authors.affiliation: Ludwig Maximilians University Munich, Munich, Germany.
authors.forename: E F
authors.initials: EF
authors.lastname: Scaparra
authors.affiliation: Centre Universitaire Romand de Médecine Légale Lausanne, Genève et Université de Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Grimm
authors.affiliation: Institute of Clinical Radiology, Klinikum Innenstadt, Ludwig Maximilians University Munich, Nussbaumstrasse 20, 80336, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Scherr
authors.affiliation: Institute of Forensic Medicine, Ludwig Maximilians University, Nussbaumstrasse 11, 80336, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Graw
authors.affiliation: Institute of Clinical Radiology, Klinikum Innenstadt, Ludwig Maximilians University Munich, Nussbaumstrasse 20, 80336, Munich, Germany.
authors.forename: M F
authors.initials: MF
authors.lastname: Reiser
authors.affiliation: Institute of Forensic Medicine, Ludwig Maximilians University, Nussbaumstrasse 11, 80336, Munich, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Peschel
mesh_terms: D001344:Autopsy; D049429:Forensic Pathology; D006801:Humans; D015588:Observer Variation; D000072142:Pathologists; D000072177:Radiologists; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Comparative study; Conventional autopsy; Forensic radiology; Gunshot; Postmortem computed tomography