The use of 3D-CT in weapon caused impression fractures of the skull, from a forensic radiological point of view

Objective: The aim of this study was to analyze the usefulness of the three-dimensional (3D) volume renderings (VRTs), based on computed tomography (CT) images of the head, to gain more insight in the etiology of impression skull fractures. Materials and methods: 3D-CT scans of 12 forensic cases with impression skull fractures after head injury were selected. Ten radiologists were asked to determine the shape of the used object, the amount of blows and the location of the fracture, based on 2D CT images and 3D volume renderings. Afterwards, the results of the assessments were compared with the real shapes of the true object in case. Results: In 7 out of 12 cases, the used weapon was a hammer. In 62% of the cases the shape of the used object was determined correctly by the radiologists and in 72% of the cases the amount of blows on the skull was correct. There was no significant difference in results between the forensically experienced and forensically inexperienced radiologists. Conclusion: 3D-CT is useful in a forensic setting, to determine the shape of a suspected weapon and the amount of blows. However, assessment of the CT data should always be combined with information about the scene and a profound morphological inspection of the wound. (C) 2013 Elsevier Ltd. All rights reserved.