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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

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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


Thank you


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