VIRTOPSY- A REVIEW

Dr. Arvind Kumar Senior Demonstrator Deptt. Of Forensic Medicine UCMS DELHI-110095

VIRTOPSY
Coined by Dr. Michael J Thali et al

VIRTOPSY= virtual + Autopsy

Essentials of virtopsy
Multi-slice Computed Tomography (MSCT)
Magnetic Resonance Imaging (MRI) Magnetic Resonance Spectroscopy 3-D/ CAD Photogrammetry

Application of Virtopsy
Atrium Mortis
Relevant forensic patho-morphologic findings Forensic Vital reactions Reconstruction of Injuries Recapitulation and Visualization

Varying density values in a 3D MSCT reconstruction in a case of blunt trauma to the head.

3D reconstruction of a skull fracture system from the MSCT data in a case of a motor vehicle accident with

the victim having been run over by a car

Coronal T2 weighted MR image showing wound track (arrows) through the brain in a suicidal gunshot case

Gadolinium enhanced MRI of patient with lateral wall myocardial infarction. Four chamber view of heart with bright signal in lateral wall of left ventricle (LV).

Figure showing comparison of spectrum from a human brain with a PMI of about 520 hours (a) and one with a PMI of 57 hours (b)

Merits and Demerits

Merits
* observer independent * reproducible * non invasive * illustrative visualization * forensic telemedicine consultation

Demerits * MRI was unable to

# image coronary artery lesions # differentiate thrombus from postmortem clot # differentiate pulmonary oedema from pneumonic exudates # detect perinatal cardiac malformations

* lack of validation * interpretative problems in advanced decomposition * considerably high costs * time consuming

Conclusion
The conventional method of Autopsy is still the gold standard

The use of imaging technology should be an autopsy adjunct rather than a replacement

Thank you