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Virtual Autopsy in Hanging

Polacco, Matteo MD*; D’Alessio, Pasquale MD; Ausania, Francesco MD*; Zobel, Bruno MD, PhD; Pascali, Vincenzo Lorenzo MD, PhD*; d’Aloja, Ernesto MD, PhD; Miscusi, Massimo MD, PhD§; De-Giorgio, Fabio MD*

The American Journal of Forensic Medicine and Pathology: June 2013 - Volume 34 - Issue 2 - p 107–109
doi: 10.1097/PAF.0b013e318288c6d6
Case Reports

The aim of the study was to compare postmortem computed tomographic (CT) imaging findings from a case of hanging with the autopsy findings. The CT showed a good match with autopsy findings especially for bone, soft tissue, and spinal injuries. The CT images of the injuries of the neck obtained by CT scan clearly showed the ligature mark, the hemorrhagic suffusion in the soft tissue (thickening of derma) and in the muscles (sternocleidomastoid) of the neck. Furthermore, CT 3-dimensional reconstruction showed brain edema, fracture of the left posterior horn of the hyoid bone, and a grade 1 retrolisthesis of C5 on C6. This last finding was not detected by autopsy because of the anterior approach that is frequently used in necropsy technique. Nevertheless, the CT virtual autopsy did not show vascular findings (like Amussat mark) because a barium mixture was not injected in the body.

From the *Institute of Legal Medicine, Medical School, Catholic University; †Department of Radiodiagnostic, Medical School, Campus Bio Medico; ‡Forensic Science Department, Cagliari University, Monserrato (CA); and §Department of Neurosurgery, Medical School, Sapienza University, Rome, Italy.

Manuscript received March 13, 2010; accepted February 2, 2011.

The authors report no conflicts of interest.

Reprints: Fabio De-Giorgio, MD, PhD, Institute of Legal Medicine, Catholic University, Largo F. Vito, 1 00168 Rome, Italy. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.