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VIRTOPSY- A REVIEW. Dr. Arvind Kumar Senior Demonstrator Deptt. Of Forensic Medicine UCMS DELHI-110095. VIRTOPSY. Coined by Dr. Michael J Thali et al VIRTOPSY= virtual + Autopsy. Essentials of virtopsy. Multi-slice Computed Tomography (MSCT) Magnetic Resonance Imaging (MRI)
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VIRTOPSY- A REVIEW • Dr. Arvind Kumar Senior Demonstrator Deptt. Of Forensic Medicine UCMS DELHI-110095
VIRTOPSY • Coined by Dr. Michael J Thali et al • VIRTOPSY= virtual + Autopsy
Essentials of virtopsy • Multi-slice Computed Tomography (MSCT) • Magnetic Resonance Imaging (MRI) • Magnetic Resonance Spectroscopy • 3-D/ CAD Photogrammetry
Application of Virtopsy • Atrium Mortis • Relevant forensic patho-morphologic findings • Forensic Vital reactions • Reconstruction of Injuries • Recapitulation and Visualization
Varying density values in a 3D MSCT reconstruction in a case of blunt trauma to the head.
3D reconstruction of a skull fracture system from the MSCT data in a case of a motor vehicle accident with the victim having been run over by a car
Coronal T2 weighted MR image showing wound track (arrows) through the brain in a suicidal gunshot case
Gadolinium enhanced MRI of patient with lateral wall myocardial infarction. Four chamber view of heart with bright signal in lateral wall of left ventricle (LV).
Figure showing comparison of spectrum from a human brain with a PMI of about 520 hours (a) and one with a PMI of 57 hours (b)
Merits and Demerits • Merits * observer independent * reproducible * non invasive * illustrative visualization * forensic telemedicine consultation
Demerits *MRI was unable to # image coronary artery lesions # differentiate thrombus from postmortem clot # differentiate pulmonary oedema from pneumonic exudates # detect perinatal cardiac malformations
* lack of validation * interpretative problems in advanced decomposition * considerably high costs * time consuming
Conclusion • The conventional method of Autopsy is still the gold standard • The use of imaging technology should be an autopsy adjunct rather than a replacement