Role of PMCT as a triage tool between external inspection and full autopsy – Case series and review

Postmortem computed tomography (PMCT) provides significant information with regard to specific forensic questions for the determination of manner and cause of death. After the external examination of a body, PMCT appears to be a valuable tool for imaging-based decision making whether conducting an autopsy is necessary. Within that domain of application, a series of ten cases is presented to qualitatively highlight the current state of the art and remaining problems. PMCT combined with detailed external examination of the body and toxicological tests can satisfactorily answer the leading forensic questions of some cases, like the validation of the victim's identity and the presence of foreign bodies and determine the cause and manner of death. By absence of suspected trauma or third party violence during the scene investigation and the external examination of a corpse, PMCT can add more validity to these assumptions or contradict those revealing unexpected findings. Thus, a conventional medicolegal autopsy can be avoided as all relevant forensic questions are answered, which is also time and cost consuming. However, reliable evaluation of relevant head and cervical trauma, strangulation, infection and sepsis, metabolic disorders, intoxication and neuroreflex deaths keeps evading a purely PMCT-based approach.