Forensic post-mortem CT in children

Post-mortem computed tomography (PMCT) imaging is gaining popularity and acceptance for use alongside forensic autopsies of children, predominantly to aid in the detection of traumatic injuries. Recent research on this topic has provided a breadth of new information regarding the appropriate usage, imaging guidance, and diagnostic accuracy for the identification of different paediatric pathologies. Additionally, advanced CT imaging techniques, such as PMCT angiography or ventilated PMCT, have been trialled, and post-mortem micro-CT is now being used in specialist centres for the assessment of subtle fractures in extracted bone specimens. Various image post-processing methods (e.g., three-dimensional printing from PMCT imaging data) are being used for the illustration of injuries in the medicolegal setting to a lay audience and provide another avenue for the future of forensic radiology research. In this review, the evidence-based principles and benefits of post-mortem imaging for forensic investigation in childhood deaths are presented, with a particular focus on PMCT and current practices. Variations in forensic imaging strategies around the world, published diagnostic accuracy rates, and expected normal post-mortem imaging findings are discussed, as well as potential future applications and research in this area. (c) 2023 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.

Automated summary

Post-mortem computed tomography (PMCT) imaging is increasingly used in forensic autopsies, especially for detecting traumatic injuries in children. Recent research has provided new information on its usage, imaging guidance, and diagnostic accuracy for identifying pediatric pathologies. Advanced CT imaging techniques, such as PMCT angiography and ventilated PMCT, have been trialed, and post-mortem micro-CT is now used for assessing subtle fractures in bone specimens. Various image post-processing methods, including three-dimensional printing from PMCT imaging data, are used to illustrate injuries to a lay audience in the medicolegal setting, offering future avenues for forensic radiology research.