investigation of erthquake related deaths using post-mortem multi detector computed tomography

Purpose: Post-mortem Multi-Detector Computed Tomography (MDCT) is now recognized as a valuable adjunct medicolegal tool. Beside its application for identification purposes, MDCT is used to assist pathologists in determining cause of death. Compared to conventional radiography MDCT offers advantages in detecting blunt force injury, and can quickly provide a guide to lethal injuries. Therefore, the use of MDCT for earthquake-related deaths is an obvious choice, as blunt force injuries are common in such victims. The purpose of this study was to evaluate the impact of MDCT on the assessment of causes of death, in a case series of fatal injuries after the 2012 Modena earthquake. Methods and materials: 12 medicolegal cases underwent full-body CT-scan and external examination. The circumstances of death were collected and reviewed. Conventional autopsy was not authorized by the local Prosecutor for all cases. Results: In all cases, post-mortem MDCT and external examination revealed lesions consistent with fatal blunt force injuries, and the absence of contrary evidence that could support another cause of death. These findings together with the circumstantial data were sufficient to assess cause and manner of death. Conclusions: The results of this study confirm that post-mortem MDCT provides an important contribution to determining cause of death, especially when autopsy is not performed. Therefore, radiologists with experience in post-mortem imaging are needed to support forensic pathologists in establishing causes of death, without necessarily having to perform conventional autopsy.