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01-08-2009 | Forensic Medicine

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

Authors: Andreas Christe, Harriet Thoeny, Steffen Ross, Danny Spendlove, Dechen Tshering, Stephan Bolliger, Silke Grabherr, Michael J. Thali, Peter Vock, Lars Oesterhelweg

Published in: European Radiology | Issue 8/2009

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 ≈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.

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Title: Life-threatening versus non-life-threatening manual strangulation: are there appropriate criteria for MR imaging of the neck?
Authors: Andreas Christe
Harriet Thoeny
Steffen Ross
Danny Spendlove
Dechen Tshering
Stephan Bolliger
Silke Grabherr
Michael J. Thali
Peter Vock
Lars Oesterhelweg
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: European Radiology / Issue 8/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1353-2

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

Abstract

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Abstract

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