Life-threatening versus non-life-threatening manual strangulation: are there appropriate criteria for MR imaging of the neck?

Details

Serval ID
serval:BIB_1F9F2B2846C9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Life-threatening versus non-life-threatening manual strangulation: are there appropriate criteria for MR imaging of the neck?
Journal
European Radiology
Author(s)
Christe A., Thoeny H., Ross S., Spendlove D., Tshering D., Bolliger S., Grabherr S., Thali M.J., Vock P., Oesterhelweg L.
ISSN
1432-1084[electronic]
Publication state
Published
Issued date
2009
Volume
19
Number
8
Pages
1882-1889
Language
english
Abstract
The aim of the study was to determine objective radiological signs of danger to life in survivors of manual strangulation and to establish a radiological scoring system for the differentiation between life-threatening and non-life-threatening strangulation by dividing the cross section of the neck into three zones (superficial, middle and deep zone). Forensic pathologists classified 56 survivors of strangulation into life-threatening and non-life-threatening cases by history and clinical examination alone, and two blinded radiologists evaluated the MRIs of the neck. In 15 cases, strangulation was life-threatening (27%), compared with 41 cases in which strangulation was non-life-threatening (73%). The best radiological signs on MRI to differentiate between the two groups were intramuscular haemorrhage/oedema, swelling of platysma and intracutaneous bleeding (all p = 0.02) followed by subcutaneous bleeding (p = 0.034) and haemorrhagic lymph nodes (p = 0.04), all indicating life-threatening strangulation. The radiological scoring system showed a sensitivity and specificity of approximately 70% for life-threatening strangulation, when at least two neck zones were affected. MRI is not only helpful in assessing the severity of strangulation, but is also an excellent documentation tool that is even admissible in court.
Keywords
Adolescent, Adult, Child, Critical Illness/classification, Female, Humans, Image Interpretation, Computer-Assisted/methods, Magnetic Resonance Imaging/methods, Male, Middle Aged, Neck Injuries/classification, Neck Injuries/diagnosis, Reproducibility of Results, Risk Assessment/methods, Risk Factors, Sensitivity and Specificity, Survivors, Trauma Severity Indices, Young Adult
Pubmed
Web of science
Create date
04/02/2010 14:24
Last modification date
20/08/2019 12:55
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