Comparative study of postmortem computed tomography (PMCT) against traditional forensic autopsy findings in fatal road traffic accidents — a pilot analysis

Abstract

Background: Virtopsy is “a virtual alternative to the traditional autopsy, conducted with scanning and imaging technology,” mainly with the use of postmortem computed tomography (PMCT). It is still in the budding stage in India. The Department of Forensic Medicine and Toxicology, All India Institute of Medical Science, New Delhi, is the first center in the country that has established a facility for virtual autopsy. This facility aims to supplement the traditional autopsy findings and also to replace/curtail internal dissection in autopsy in the future, for which there has always been an aversion in relatives of the deceased due to emotional and religious reasons. The PMCT being a noninvasive, preservative, and objective procedure would be preferred by relatives than traditional autopsy. So, in this regard, this pilot study was conducted with the objective for comparison of PMCT vs traditional autopsy findings in fatal road traffic accidents to analyze its advantages and limitations in order to replace/augment the traditional autopsy with PMCT in the near future in road traffic accident cases. Results: The authors evaluated 10 cases of road traffic accident victims. In each case, an autopsy was preceded by a PMCT examination using a 16-slice Multi-Slice CT spiral scanner. The fractures of the skull, facial bones, clavicle, scapula, and vertebra were located more precisely as compared to traditional autopsy. Interpretation of the ventricular hemorrhages of the brain is much better in PMCT. PMCT should be the investigation of choice for pneumothorax, pneumoperitoneum, pneumocephalus, and hemosiuns, while it needs further exploration to detect injuries of soft tissues as out of 14 injuries only 2 were identified by PMCT. Conclusions: The procedure of whole-body PMCT followed by region-wise CT can be studied for a better PMCT acquisition to detect soft tissue injury findings more precisely. However, the PMCT in this study was able to conclude the cause of death in a more scientific way than the traditional autopsy.