Case details

Data sets available: ******* not specified. CT.CT, MRI. CT, Angiography.

Forensic question: In this case there was no actual or concise question to be answered by forensic imaging.

Overview

Body constitution: ******* not examined. normal. overweight for height. underweight for height.

Foreign material: ******* not examined. no foreign material visible on overview. foreign material in the region of the dentition.

Other general aspect findings: item ******* not checked. no additional remarks. post mortem decomposition.

Medical devices and installations

Body surface: ******* not checked. no medical devices or installations. Body surface electrodes. Body surface electrodes, defibrillator patches.

Internally located devices: ******* not checked. no internally located devices. endotracheal tube, regular position. larynx tube, regular position.

Head and neck

Soft tissues - deformation, swelling, hematoma: ******* not checked. no findings. swelling, gas (putrefaction).

Soft tissues - calcification: ******* not checked. no findings. present,

Soft tissues - foreign material: ******* not checked. no foreign material. earrings.

Soft tissues - defect: ******* not checked. no defect. consistent with firearm injury defects, . unascertainable (post mortem decomposition).

Soft tissues - eyes: ******* not checked. regular, symmetrical. unascertainable. unascertainable (post mortem decomposition).

Skull - bone 3D volume rendering, cropped to expose skull base, full inspection: ******* not checked. intact, regular shape.

Skull - bone of neurocranium: ******* not checked. regular shape, intact.

Skull - bone of viscerocranium: ******* not checked. regular shape, intact.

Skull - bone defect: ******* not checked. no defect.

Skull - bone, foreign material: ******* not checked. no foreign material.

Skull - bone, sella turcica: ******* not checked. regular.

Skull - bone tumor, bone swelling, bone hyperostosis: ******* not checked. regular shape, regular thickness.

Paranasal sinuses - contents: ******* not checked. gas / air. level indicative of fluid. swelling of mucous membranes.

Skull cavity: ******* not checked. no pathology. subdural hemorrhage, epidural hemorrhage, subarachnoid hemorrhage, gas / pneumencephalon, gas (post mortem decomposition).

Skull - auditory canals: ******* not checked. patent. cerumen. foreign material.

Brain - symmetry: ******* not checked. symmetrical. shifted / not in place, shifted / not in place (putrefaction).

Brain - normal calcifications: ******* not checked. none. present (pineal gland).

Brain - sulci: ******* not checked. hard to delineate (normal post mortem finding). remarkably wide. remarkably narrow (including temporo-frontal sulcus).

Brain - basal ganglia: ******* not checked. normal. unascertainable (post mortem decomposition).

Brain - basal meninges and cisterns: ******* not checked. no findings suspicious of subarachnoid hemorrhage. slight increase in CT density as consequence of congestion or possible subarachnoid hemorrhage. subarachnoid hemorrhage.

Brain - foreign material: ******* not checked. no foreign material.

Brain - circumscript / localized findings: ******* not checked. none. parenchymal hemorrhage/s, cortical contusions,

Brain - pituitary gland: ******* not checked. region of pituitary gland with normal CT aspect. not verifiable (post mortem decomposition).

Brain - lateral ventricle symmetry: ******* not checked. relatively symmetric. not verifiable (post mortem decomposition).

Brain - width of lateral ventricles: ******* not checked. medium. narrow. wide.

Brain - ventricle content: ******* not checked. normal, with/without normal calcifications. CT-density of blood.

Brain - dura mater, falx cerebri: ******* not checked. normal, with/without normal calcifications. .

Brain - region of Circle of Willis: ******* not checked. inconspicuous. Calcifications. suspected blood vessel widening / dilatation.

Head - dentition: ******* not checked. inconspicuous. dental applications present. atrophied jaws, no teeth present.

Head - status of dental applications: ******* not checked. no request to perform dental ID present. no dental applications present. decayed teeth remaining,

Head / neck - oral cavity, pharynx, laryngeal structures: ******* not checked. inconspicuous. identifiable foreign material,

Neck - skin, subcutaneous fat, muscles: ******* not checked. symmetric, inconspicuous, no gas or emphysema, no hemorrhage, no foreign material, no calcification, no tissue mass, no defects. emphysema, gas, relatively symmetrically distributed (putrefaction).

Neck - thyroid gland: ******* not checked. inconspicuous, symmetrical, no tumor, no calcification. calcification, cannot be delineated or identified (putrefaction).

Neck - vessels: ******* not checked. inconspicuous. calcifications. gas / air. gas (putrefaction). congestion/dilation/distension.

Cervical spine - 3D / MIP / VRT: ******* not checked. inconspicuous. foreign material, luxation/s,

Cervical spine - sagittal view: ******* not checked. inconspicuous. degenerative changes, intervertebral disc/s with gas, fracture/s,

Cervical spine - spinal canal - sagittal view: ******* not checked. inconspicuous. mass, narrowing, emphysema, lesion,

Cervical spine - axial view: ******* not checked. inconspicuous. emphysema of surrounding soft tissues, vertebral body fracture/s, fracture/s of transverse process/es, fracture/s of spinous process/es,

Cervical spine - spinal canal- axial view: ******* not checked. inconspicuous. mass, narrowing, emphysema, lesion,

Hyoid bone in-plane axial MPR, thyroid cartilage sagittal MPR, zoomed in to fill screen / window: ******* not checked. inconspicuous, regular appearance, no dehiscence, symmetric, correct position and alignment, no fissure, no bend, no surrounding or adjacent gas or emphysema. bend, suspected anatomical variation, fracture,

Chest, abdomen, extremities

Chest, abdomen, back - skin, subcutaneous fat, muscle: ******* not checked. normal. defect, emphysema, diffusely increased fluid content (anasarca). gas / emphysema (putrefaction).

Abdomen - umbilicus, groins: ******* not checked. no hernia.

Chest - mammary glands: ******* not checked. regular / inconspicuous. implant/s, gas / emphysema (putrefaction).

Skeleton - configuration 3D / VRT: ******* not checked. complete, normal alignment and relative position of bones, no fractures discernible at that level of detail. fractures, older fractures, foreign material,

Skeleton - ribs: ******* not checked. inconspicuous. fracture/s, callus formation, foreign material,

Skeleton - sternum: ******* not checked. inconspicuous. fracture, Cerclages. foreign material,

Skeleton - shoulder girdle (clavicles, scapulae): ******* not checked. inconspicuous. fracture/s

Thoracic and lumbar spine - 3D / MIP / VRT: ******* not checked. inconspicuous, regular alignment. foreign material,

Thoracic and lumbar spine - sagittal view: ******* not checked. inconspicuous. degenerative changes, intervertebral disc/s with gas, fracture/s,

Thoracic and lumbar spine - spinal canal - sagittal view: ******* not checked. inconspicuous. mass, narrowing,

Thoracic and lumbar spine - axial: ******* not checked. inconspicuous. emphysema of surrounding soft tissues, vertebral body fracture/s, fracture/s of transverse process/es, fracture of spinous process/es,

Thoracic and lumbar spine - spinal canal - axial: ******* not checked. inconspicuous. mass, narrowing,

Lungs: ******* not checked. inconspicuous post mortem lung CT appearance with hypostasis according to body position on the back, no indication of consolidation, no emphysema, no foreign material, airways patent, no gas in blood vessels, no parabronchial gas, no diffuse or circumscript pathology, no nodules or masses, no calcification. consolidation, emphysema, reduced or absent hypostasis (consider additional tests for hypothermia, blood loss, mechanical suffocation), lung changes due to putrefaction.

Lungs - trachea, bronchi: ******* not checked. patent, no conspicuous content. containing material, gas / air adjacent to trachea/bronchi, calcification/s,

Airways - tube: ******* not checked. no tube in place. endotracheal tube, regular position. larynx mask, regular position.

Lungs - pleural cavity: ******* not checked. inconspicuous, no pleural effusion, no pneumothorax, pleura not thickened. pneumothorax, pleural effusion, gas/fluid (putrefaction)=, calcification in the apical region of the lungs.

Mediastinum: ******* not checked. inconspicuous - not widened, not shifted, no gas / emphysema. shifted, emphysema, lymph nodes, widening,

Aorta thoracalis und abdominalis: ******* not checked. inconspicuous, easy to delineate, regular round or oval shape (but not flat or collapsed), no dilation or aneurysm, no foreign material, no vessel graft. calcification. suspected rupture. gas. collapse.

Vena cava superior: ******* not checked. inconspicuous, easy to delineate, regular round or oval shape (but not flat or collapsed), no dilation. collapse, not well delineated (putrefaction).

Conus pulmonalis, pulmonary arteries: ******* not checked. inconspicuous, easy to delineate, regular Y-shape, content with sedimented aspect. lumen containing heterogenous structure, cannot be clearly delineated (putrefaction).

Pericard: ******* not checked. intact, easy to delineate. hemopericardium. armored heart sign (fibrosis, calcification, indicator for possible constrictive pericarditis). pericardial effusion, cannot be easily delineated (putrefaction)

Heart - left ventricle: ******* not checked. size wise normal aspect. measured (area), cardiomegaly.

Heart - myocardial walls: ******* not checked. continuously homogenous appearance, relatively undisrupted.

Heart - calcification: ******* not checked. no calcification present. coronary artery calcification, Verkalkungen der Koronarien und Herzklappen.

Heart - content: ******* not checked. no gas, inconspicuous. gas (small amount). hard to delineate (putrefaction).

Diaphragm (coronary MPR): ******* not checked. inconspicuous, no hernia. anterior retrosternal hernia (Morgagni). posterolateral hernia (Bochdalek). hiatus hernia. traumatic hernia.

Diaphragm position: ******* not checked. normal, between ribs IV and XIII. determined exactly,

Liver: ******* not checked. normal, parenchyma homogenous, vessels without gas. focal pathology, increased fat content, density difference compared to spleen in excess of 10 Hounsfield units. vessels with gas (putrefaction).

Gall bladder: ******* not checked. homogenous, normal. gall stones. could not be delineated.

Spleen: ******* not checked. normal, inconspicuous, well delineated, homogenous parenchyma. focal pathology, accessory spleen/s, could not be clearly delineated (putrefaction).

Kidneys: ******* not checked. regular position, two kidneys present, well delineated circumference, no calcifications. hypodense focal pathology/ies (consistent with benign serous cysts).gas (putrefaction).

Adrenal glands: ******* not checked. regular position, well delineated, Y shaped in cross section, slender. mass/tumor, hard to delineate (putrefaction).

Pancreas: ******* not checked. inconspicuous, well delineated. atrophied appearance. calcification/s, difficult to delineate (putrefaction).

Urinary bladder: ******* not checked. inconspicuous, horizontal diameter < 7 cm. horizontal diameter increased (indicating full bladder), mass lesion, catheter, difficult to delineate (putrefaction).

Reproductive organs: ******* not checked. inconspicuous. calcification/s, foreign material, gas, and / or difficult to delineate (putrefaction).

Abdominal cavity: ******* not checked. inconspicuous, mesenterial fat isodense. fluid, gas, gas (putrefaction).

Gastric contents: ******* not checked. average amount, inconspicuous, relatively homogenous. sedimented and/or CT-dense material possibly indicative of drugs, gas, foreign material, difficult to delineate (putrefaction).

Intestine: ******* not checked. inconspicuous wall and content, average amount of gas. gas,

Gastrointestinal tract - specific search for foreign bodies inc. body packing: ******* not checked. the whole gastrointestinal tract was specifically checked for suspicious findings regarding foreign bodies, foreign material, including body packs, but none were found. suspected SIM card,

Large arteries and veins: ******* not checked. regular width, regular round or oval cross sectional appearance, no calcification. calcifications along arteries. gas, cross section/s flat or collapsed,

Lymph nodes: ******* not checked. inconspicuous, not enlarged, no calcifications.

Right arm - skin, fat, muscle: ******* not checked. muscles not atrophic, no emphysema, no defect, no mass lesion, no CT density increase, no foreign material. increased CT density, foreign material, gas (putrefaction). normal as far as visible (extremity partly not contained or depicted on data / artifacts).

Right arm - configuration skeleton: ******* not checked. regular, normal, complete. fracture/s,

Right arm - humerus, radius, ulna: ******* not checked separately. inconspicuous. fracture/s,

Right arm - carpal bones: ******* not checked separately. inconspicuous. fracture/s,

Right arm - metacarpal and digital bones: ******* not checked separately. inconspicuous. fracture/s,

Left arm - skin, fat, muscle: ******* not checked. muscles not atrophic, no emphysema, no defekt, no mass lesion, no CT density increase, no foreign material. increased CT density, foreign material, gas (putrefaction). normal as far as visible (extremity partly not contained or depicted on data / artifacts).

Left arm - configuration skeleton: ******* not checked. regular, normal, complete. fracture/s,

Left arm - humerus, radius, ulna: ******* not checked separately. inconspicuous. fracture/s,

Left arm - carpal bones: ******* not checked separately. inconspicuous. fracture/s,

Left arm - metacarpal and digital bones: ******* not checked separately. inconspicuous. fracture/s,

Pelvis - configuration skeleton: ******* not checked. regular, normal, symmetric. fracture/s,

Right leg - skin, fat, muscle: ******* not checked. muscles not atrophic, no emphysema, no defekt, no mass lesion, no CT density increase, no foreign material. increased CT density, foreign material, gas (putrefaction). normal as far as visible (extremity partly not contained or depicted on data / artifacts).

Right leg - configuration skeleton: ******* not checked. regular, normal, complete. fracture/s,

Right leg - femur: ******* not checked separately. inconspicuous. fracture/s,

Right leg - tibia: ******* not checked separately. inconspicuous. fracture/s,

Right leg - fibula: ******* not checked separately. inconspicuous. fracture/s,

Right leg - foot, skeleton: ******* not checked separately. inconspicuous. fracture/s,

Left leg - skin, fat, muscle: ******* not checked. muscles not atrophic, no emphysema, no defekt, no mass lesion, no CT density increase, no foreign material. increased CT density, foreign material, gas (putrefaction). normal as far as visible (extremity partly not contained or depicted on data / artifacts).

Left leg - configuration skeleton: ******* not checked. regular, normal, complete. fracture/s,

Left leg - femur: ******* not checked separately. inconspicuous. fracture/s,

Left leg - tibia: ******* not checked separately. inconspicuous. fracture/s,

Left leg - fibula: ******* not checked separately. inconspicuous. fracture/s,

Left leg - foot, Skeleton: ******* not checked separately. inconspicuous. fracture/s,

Ancillary examinations: ******* (unascertained statement). no further examinations were done as part of forensic imaging in this case. MRI: post mortem lung ventilation: angiography:

Summary of findings, interpretation: