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Atlas of Postmortem Angiography
Springer International Publishing
Injuries inflicted by gunshot trauma result from different kinds of firearms and similar devices. Ballistic trauma can produce damage to tissues that is quite similar to that inflicted by other types of instruments involved in mechanical trauma, but because of the transfer of a large amount of energy, firearm injuries can be extremely destructive. Additionally, some specific questions relate to the investigation of gunshot injury cases. The following features are important for forensic reconstruction of the event: locating and distinguishing the entrance and exit wounds, the range of fire, the bullet course through the body (trajectory), and remaining projectiles or their fragments as well as information about the kind of missile. In recent years, postmortem computed tomography (PMCT) has been gradually replacing x-ray examination for this purpose in forensic death investigations. This technology offers special opportunities for investigating gunshot trauma cases, especially through the simple detection of foreign bodies such as projectiles, a high sensitivity for detecting bone lesions, and the possibility of multiplanar reconstructions that allow visualization of trajectories and generation of three-dimensional (3D) images. To perform diagnosis concerning lesions of the vascular system, soft tissue, and parenchymatous organs, the sensitivity of PMCT can be greatly increased by postmortem angiography (PMCTA). Because firearm lesions can appear at multiple sites of the body and rarely concern only one organ, whole-body angiography methods are the tools of choice for investigating these lesions and their consequences. This chapter explains the possibilities offered by the technique of multiphase PMCT angiography (MPMCTA), which is regularly applied in cases of firearm injuries in our centers.
Gunshot trauma Firearm injuries Distance of shot Localization of projectiles Injury track estimation
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