Technical note: reliability of Suchey-Brooks and Buckberry-Chamberlain methods on 3D visualizations from CT and laser scans.

YesPrevious studies have reported that the ageing method of Suchey-Brooks (pubic bone) and some of the features applied by Lovejoy et al. and Buckberry-Chamberlain (auricular surface) can be confidently performed on 3D visualizations from CT-scans. In this study, seven observers applied the Suchey-Brooks and the Buckberry-Chamberlain methods on 3D visualizations based on CT-scans and, for the first time, on 3D visualizations from laser scans. We examined how the bone features can be evaluated on 3D visualizations and whether the different modalities (direct observations of bones, 3D visualization from CT-scan and from laser scans) are alike to different observers. We found the best inter-observer agreement for the bones versus 3D visualizations, with the highest values for the auricular surface. Between the 3D modalities, less variability was obtained for the 3D laser visualizations. Fair inter-observer agreement was obtained in the evaluation of the pubic bone in all modalities. In 3D visualizations of the auricular surfaces, transverse organization and apical changes could be evaluated, although with high inter-observer variability; micro-, macroporosity and surface texture were very difficult to score. In conclusion, these methods were developed for dry bones, where they perform best. The Suchey-Brooks method can be applied on 3D visualizations from CT or laser, but with less accuracy than on dry bone. The Buckberry-Chamberlain method should be modified before application on 3D visualizations. Future investigation should focus on a different approach and different features: 3D laser scans could be analyzed with mathematical approaches and sub-surface features should be explored on CT-scan

Imagerie en coupe et anthropobiologie : applications médico-légales pour la détermination de l'âge

Le but de ce travail était d'évaluer d'une part, et de valider d'autre part les possibilités offertes par l'imagerie en coupe dans le domaine de l'estimation de l'âge d'individus vivants ou de l'estimation de l'âge au décès. Ce travail a ainsi porté sur l'étude d'individus vivants et de pièces osseuses préparées. Pour ce faire, plusieurs moyens d'imagerie ont été utilisés : la tomodensitométrie multicoupe et l'imagerie par résonance magnétique. Ce travail était en premier lieu basé sur la transposition en tomodensitométrie de critères ostéoscopiques utilisés en anthropologie physique lorsqu'une problématique de détermination d'âge au décès d'un individu non identifié vient à se poser, ainsi que la validation de ces critères. Parallèlement, des critères propres à l'imagerie en coupe ont également été recherchés et validés. Plusieurs éléments anatomiques ont été retenus : les premières et quatrièmes côtes droites, l'os coxal par l'étude de la surface auriculaire et de la symphyse pubienne, et enfin l'articulation fémoro-tibiale. Ce travail a permis la mise en évidence d'un réel apport de l'imagerie en coupe en terme d'estimation d'âge d'individus, qu'ils soient vivants ou décédés. Son application pratique sur des momies est une aide précieuse de part le caractère non invasif de l'exploration par imagerie. La réalisation d'examens en coupe à visée anthropologique présente de nombreux avantages. Les images sont stockables, interprétables a posteriori, transférables par le biais d'internet ou l'envoi de supports. De plus, les reconstructions effectuées peuvent être, si elles sont rassemblées sur un site internet, un véritable musée virtuelThe goal of this work was to evaluate on the one hand, and to validate on the other hand the possibilities offered by the modern cross-sectional imaging in the field of the age estimation of living persons or the estimation of the age-at-death of deceased. This work concerned the study of living individuals and prepared bone pieces. With this intention, several kinds of imaging were used: the multislice computed tomography and the magnetic resonance imaging. This work was initially based on the transposition in multislice computed tomography of osteoscopic criteria used in physical anthropology when problems of determination of age-at-death of not identified individuals is encountered, as well as the validation of these criteria. In parallel, proper criteria for modern cross-sectional imaging were sought and validated. Several anatomical elements were retained: right first and fourth ribs, the innominate bone by the study of the auricular surface and the pubic symphysis, and finally the knee joint. This work allowed the description of a real contribution of modern cross-sectional imaging in term of age estimation of individuals, alive or died. The practical application on mummies is an invaluable help because of the non invasive character of the imaging exploration. The realization of modern cross-sectional imaging explorations with anthropological aims has many advantages. The images are storable, retrospectively interpretable, and transferable by Internet or the sending of supports. Moreover, the reconstructions carried out can be, if they are gathered on an Internet site, a real virtual anthropological museu

Modern post-mortem imaging: an update on recent developments

Modern post-mortem investigations use an increasing number of digital imaging methods, which can be collected under the term “post-mortem imaging”. Most methods of forensic imaging are from the radiology field and are therefore techniques that show the interior of the body with technologies such as X-ray or magnetic resonance imaging. To digitally image the surface of the body, other techniques are regularly applied, e.g. three-dimensional (3D) surface scanning (3DSS) or photogrammetry. Today's most frequently used techniques include post-mortem computed tomography (PMCT), post-mortem magnetic resonance imaging (PMMR), post-mortem computed tomographic angiography (PMCTA) and 3DSS or photogrammetry. Each of these methods has specific advantages and limitations. Therefore, the indications for using each method are different. While PMCT gives a rapid overview of the interior of the body and depicts the skeletal system and radiopaque foreign bodies, PMMR allows investigation of soft tissues and parenchymal organs. PMCTA is the method of choice for viewing the vascular system and detecting sources of bleeding. However, none of those radiological methods allow a detailed digital view of the body's surface, which makes 3DSS the best choice for such a purpose. If 3D surface scanners are not available, photogrammetry is an alternative. This review article gives an overview of different imaging techniques and explains their applications, advantages and limitations. We hope it will improve understanding of the methods

Hidden lesions: a case of burnt remains.

One of the many challenging cases that forensic pathologists, anthropologists, and forensic imaging experts have to face are burnt human remains. Perpetrators frequently attempt to hide/destroy evidence and make the body unidentifiable by exposing it to fire. We present a case of a partially burnt body found in an apartment after an explosion. First, multidetector computed tomography (MDCT) images and the following autopsy revealed several lesions on the cranium. Forensic anthropologists were involved in order to specify the aetiology of the lesions observed on the cranium. Through an interdisciplinary approach bringing together MDCT scans, 3D surface scans, and anthropological analysis, it was possible to answer the questions raised during the autopsy. Analyses demonstrated that there were signs of blunt force trauma on the cranium vault that the perpetrator likely attempted to hide by exposing the body to fire. This case demonstrates the importance of close collaboration between forensic anthropologists, imaging experts, and forensic pathologists. This multidisciplinary approach allows for a better, more complete reconstitution of forensic cases. The analyses of burnt human remains are one of the many challenging tasks that forensic pathologists and anthropologists have to face.We present an occurrence of a partially burnt body after an explosion and forensic anthropologists were asked whether the nature of the lesions observed on the cranium could be further specified.Anthropological analyses of the skull were consistent with the radiological and autopsy report. It was possible to reconstruct the various lesions on the dry bone.The case demonstrates the importance of an interdisciplinary approach and the close collaboration between forensic anthropologists, imaging experts, and forensic pathologists

Postmortem coronary artery calcium score in cases of myocardial infarction.

Sudden cardiac death (SCD) related to atherosclerotic coronary artery disease (ACAD) resulting in myocardial infarction is the most prevalent cause of death in western countries. In clinical practice, coronary artery calcium score (CACS) is considered an independent predictor of coronary events, closely related to atherosclerotic burden and is quantified radiologically by the Agatston score being calculated through computed tomography. Postmortem computed tomography (PMCT) allows the visualization and quantification of coronary calcifications before the autopsy. However, it was reported that some patients who died from severe ACAD had a zero CACS in PMCT. In this study, a retrospective evaluation of CACS in adult's myocardial infarction cases related to ACAD, with available CACS and histological slides of coronary arteries, was performed in order to gain a deeper understanding of coronary calcifications and their role in myocardial infarction cases. The CACS was calculated by using the software Smartscore 4.0 after the radiological examination on a 64-row CT unit using a specific cardiac protocol. Thirty-six cases were identified out of 582 autopsies, recorded during a 2-year study period (29 men, 7 women; age 56.3 ± 11.7). CACS was 0-10 in 5 cases (5 men, 44.8 ± 13.7), 11-100 in 8 cases (6 men, 2 women, 53.1 ± 7.7), 101-400 in 13 cases (11 men, 2 women, 57.4 ± 9.6), and > 400 in 10 cases (9 men, 1 woman, 63.1 ± 11.9). Coronary thrombosis was found in 28 cases, histologically identified as plaque erosions in 6 cases and as plaque ruptures in 22 cases. Statistical analyses showed that CACS increases significantly with age (p-value < 0.05) and does not show significant correlation with gender, body weight, body mass index, and heart weight. CACS was significantly higher in plaque ruptures than in plaque erosions (p-value < 0.01). Zero or low CACS on unenhanced PMCT cannot exclude the presence of myocardial infarction related to ACAD. This paradoxical discrepancy between imaging and autopsy findings can be explained considering the histological aspect of fatal coronary plaques

Procedures and Frequencies of Embalming and Heart Extractions in Modern Period in Brittany. Contribution to the Evolution of Ritual Funerary in Europe.

The evolution of funeral practices from the Middle Ages through the Modern era in Europe is generally seen as a process of secularization. The study, through imaging and autopsy, of two mummies, five lead urns containing hearts, and more than six hundred skeletons of nobles and clergymen from a Renaissance convent in Brittany has led us to reject this view. In addition to exceptional embalming, we observed instances in which hearts alone had been extracted, a phenomenon that had never before been described, and brains alone as well, and instances in which each spouse's heart had been placed on the other's coffin. In some identified cases we were able to establish links between the religious attitudes of given individuals and either ancient Medieval practices or more modern ones generated by the Council of Trent. All of these practices, which were a function of social status, were rooted in religion. They offer no evidence of secularization whatsoever

Analysis of size and shape differences between ancient and present-day Italian crania using metrics and geometric morphometrics based on multislice computed tomography

The Museum of Human Anatomy in Naples houses a collection of ancient Graeco-Roman crania. The aim of this study was to use multislice computed tomography (MSCT) to evaluate and objectively quantify potential differences in cranial dimensions and shapes between ancient Graeco-Roman crania (n = 36) and modern-day southern Italian crania (n = 35) and then to characterize the cranial changes occurring over more than 2000 years, known as secular change. The authors used traditional metric criteria and morphometric geometry to compare shape differences between the sets of crania. Statistically significant differences in size between the ancient and modern crania included shorter facial length, narrower external palate, smaller minimum cranial breadth, shorter right and left mastoid processes, and wider maximum occipital and nasal breadth. The shape changes from the ancient to modern crania included a global coronal enlargement of the face and cranial diameters, with more anterior projection of the face at the anterior nasal spine, but also posterior projection at the glabella and the nasion. It is not possible to determine whether these differences result exclusively from secular changes in the cranium or from other factors, including a mix of secular change and other unknown factors. To the best of our knowledge, this is the first MSCT-based study to compare ancient Graeco-Roman and modern-day southern Italian crania and to characterize shape and size differences

Bone age estimation based on multislice computed tomography study of the scapula

Progress in medical imaging has opened new areas of research in forensic anthropology, especially in the context of the study of bone age assessment. The study of bone age has become a useful tool for age estimation at death or age of young adult migrants in an anthropological context. We retrospectively evaluated multislice computed tomography (MSCT) explorations focused on scapulae of 232 individuals (123 males; 109 females) aged between 8 and 30 years old. Computed tomography (CT) scans were viewed in axial and multiplanar reconstructed images using OsiriX 5.9 (64 bit)®. The ossification centers of the scapula studied were as follows: acromial, sub-coracoid, glenoid, coracoid, coracoid apex, and inferior angle epiphyses. Fusion status was scored based on a five-stage system (stage 1: no ossification, stage 2: visualization of an ossification center, stage 3: partial ossification, stage 4: full ossification associated to an epiphyseal scar, and stage 5: full ossification without epiphyseal scar). Intra-observer variability was excellent, and inter-observer variability was good, demonstrating the reliability of this MSCT staging system. The fusion of scapular ossification centers was statistically associated with age (p  0.05). In conclusion, MSCT of the scapula is an efficient method for age assessment, which is complementary to preexisting methods particularly for specifying the 18-year threshold. Further studies with larger groups are needed to support our results

Examen médical des personnes victimes de violence : fréquence des facteurs aggravants au sens du Code pénal, hétérogénéité des pratiques

Objectifs En cas de violences volontaires, le Code pénal reconnaît l’existence de facteurs aggravants. Aucune donnée n’est disponible sur la fréquence des facteurs aggravants lors des situations de violence. L’objectif principal était de déterminer cette fréquence. L’objectif secondaire était de préciser les résultats de la détermination d’incapacité totale de travail (ITT) dans plusieurs consultations médico-judiciaires en France. Méthodes Le recueil de données prospectif porte sur six centres et 300 situations de violence. Les éléments recueillis concernaient l’existence de facteurs aggravants, les caractéristiques de la victime et des violences, les résultats de l’examen médical et les facteurs intervenus dans la détermination de l’ITT. Résultats Il existait un facteur aggravant dans 232 cas sur 300, 77 %. La durée médiane d’ITT était de deux jours (extrêmes : 0–60). La fréquence des cas sans ITT était comprise entre 0 et 56 % selon les centres (Chi2, p < 0,0001). Les médecins examinateurs considéraient ne pas avoir évalué l’état psychique dans 63 cas (21 %), d’importantes différences étant observées selon les centres (p < 0,0001). L’ITT était surtout fondée sur des éléments lésionnels dans 45 % des cas et sur des éléments fonctionnels dans 55 % des cas, cette répartition variant selon les centres (p = 0,01). L’état psychique était prépondérant dans la détermination de l’ITT dans 0 à 23 % des cas selon les centres (p = 0,009)

An unusual intracardiac foreign body following penetrating thoracic injury

Foreign bodies in the heart after thoracic trauma may result in fatal outcome. We report a pendant inside the pericardium after penetrating injury that did not cause major cardiac injury with a favorable outcome