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Published in: International Journal of Legal Medicine 6/2021

Open Access 01-11-2021 | Ultrasound | Review

Ultrasound in legal medicine—a missed opportunity or simply too late? A narrative review of ultrasonic applications in forensic contexts

Authors: Dustin Möbius, Antonia Fitzek, Niels Hammer, Axel Heinemann, Alexandra Ron, Julia Schädler, Johann Zwirner, Benjamin Ondruschka

Published in: International Journal of Legal Medicine | Issue 6/2021

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Abstract

Objectives

Conventional autopsies remain the gold standard of postmortem healthcare quality assurance and help gathering extended knowledge on diseases. In answer to constantly declining autopsy rates non- or minimally invasive autopsy methods were introduced. Ultrasound is a well-established tool for imaging commonly used in clinical practice. This narrative review aims to summarize the current literature regarding the feasibility and validity of ultrasound in a forensic context.

Material and methods

A PubMed database search was carried out. Abstracts were scanned for pre-defined ex- and inclusion criteria, followed by a snowball search procedure applied to the primarily included articles.

Results

Forty-five publications met our inclusion criteria. The selected articles concern the feasibility of ultrasound in pre- or postmortem settings, forensic age estimation, and minimally invasive approaches. For imaging, ultrasound was deemed a reliable tool for the examination of epiphyses und superficial wounds, with limitations regarding internal organs and image quality due to postmortem changes. Ultrasound-guided minimally invasive approaches yielded higher success rates for adequate tissue sampling. Many investigations were carried out in low- and middle-income countries focusing on infectious diseases.

Conclusion

Ultrasound seems a promising but underutilized imaging tool in legal medicine to date. Promising approaches on its feasibility have been conducted. Especially for minimally invasive methods, ultrasound offered significant improvements on qualified biopsy sampling and thus appropriate diagnostics. Moreover, ultrasonic evaluation of epiphyses for age estimation offered valuable results. Nevertheless, further assessment of ultrasonic feasibility in forensic contexts is needed.
Literature
18.
go back to reference Buckley MB, Clark KR (2017) Forensic age estimation using the medial clavicular epiphysis: a study review. Radiol Technol 88(5):482–498PubMed Buckley MB, Clark KR (2017) Forensic age estimation using the medial clavicular epiphysis: a study review. Radiol Technol 88(5):482–498PubMed
20.
go back to reference Wohlin C (2014) Guidelines for snowballing in systematic literature studies and a replication in software engineering. In: Proceedings of the 18th International Conference on Evaluation and Assessment in Software Engineering - EASE ’14. ACM Press 1–10. https://doi.org/10.1145/2601248.2601268 Wohlin C (2014) Guidelines for snowballing in systematic literature studies and a replication in software engineering. In: Proceedings of the 18th International Conference on Evaluation and Assessment in Software Engineering - EASE ’14. ACM Press 1–10. https://​doi.​org/​10.​1145/​2601248.​2601268
27.
go back to reference Cotton JM, Cooke JC, Monaghan MJ (2000) Forensic echocardiography: a case in point. Echocardiography 2:193–194CrossRef Cotton JM, Cooke JC, Monaghan MJ (2000) Forensic echocardiography: a case in point. Echocardiography 2:193–194CrossRef
28.
go back to reference Gniadecka M, Danielsen L (1995) High-frequency ultrasound for torture-inflicted skin lesions. Acta Derm Venereol (Stockh) 75:375–376 Gniadecka M, Danielsen L (1995) High-frequency ultrasound for torture-inflicted skin lesions. Acta Derm Venereol (Stockh) 75:375–376
46.
go back to reference Fariña J, Millana C (1998) Applications of ultrasonography on the post-mortem examination (ecopsy) in humans. J Echogr Med Ultrasons 19:280–286 Fariña J, Millana C (1998) Applications of ultrasonography on the post-mortem examination (ecopsy) in humans. J Echogr Med Ultrasons 19:280–286
57.
go back to reference Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A (2013) Sonographic examination on the time frame of ossification of the distal fibula epiphysis. Arch Kriminol 231(5–6):156–165PubMed Schulz R, Schiborr M, Pfeiffer H, Schmidt S, Schmeling A (2013) Sonographic examination on the time frame of ossification of the distal fibula epiphysis. Arch Kriminol 231(5–6):156–165PubMed
73.
go back to reference Huston BM, Malouf NN, Azar HA (1996) Percutaneous needle autopsy sampling. Mod Pathol 9:1101–1107PubMed Huston BM, Malouf NN, Azar HA (1996) Percutaneous needle autopsy sampling. Mod Pathol 9:1101–1107PubMed
80.
go back to reference Wichmann D, Heinemann A, Weinberg C et al (2014) Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study. Ann Intern Med 160(8):534–541. https://doi.org/10.7326/M13-2211CrossRefPubMed Wichmann D, Heinemann A, Weinberg C et al (2014) Virtual autopsy with multiphase postmortem computed tomographic angiography versus traditional medical autopsy to investigate unexpected deaths of hospitalized patients: a cohort study. Ann Intern Med 160(8):534–541. https://​doi.​org/​10.​7326/​M13-2211CrossRefPubMed
83.
Metadata
Title
Ultrasound in legal medicine—a missed opportunity or simply too late? A narrative review of ultrasonic applications in forensic contexts
Authors
Dustin Möbius
Antonia Fitzek
Niels Hammer
Axel Heinemann
Alexandra Ron
Julia Schädler
Johann Zwirner
Benjamin Ondruschka
Publication date
01-11-2021
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Legal Medicine / Issue 6/2021
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-021-02661-5

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