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

Christe, Andreas; Thoeny, Harriet; Ross, Steffen; Spendlove, Danny; Tshering, Dechen; Bolliger, Stephan; Grabherr, Silke; Thali, Michael J; Vock, Peter; Oesterhelweg, Lars (2009). Life-threatening versus non-life-threatening manual strangulation: are there appropriate criteria for MR imaging of the neck? European radiology, 19(8), pp. 1882-9. Berlin: Springer-Verlag 10.1007/s00330-009-1353-2

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Medicine
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Management
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Imaging
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine

UniBE Contributor:

Christe, Andreas; Thöny, Harriet C.; Ross, Steffen; Spendlove, Danny; Tshering Vogel, Dechen Wangmo; Bolliger, Stephan; Thali, Michael and Vock, Peter

ISSN:

0938-7994

Publisher:

Springer-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:12

Last Modified:

26 Jun 2018 15:01

Publisher DOI:

10.1007/s00330-009-1353-2

PubMed ID:

19283386

Web of Science ID:

000267680700007

BORIS DOI:

10.7892/boris.31731

URI:

https://boris.unibe.ch/id/eprint/31731 (FactScience: 196395)

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