Whole-body post mortem CT angiography (PMCTA) is an innovative and experimental imaging technique that relies heavily on interdisciplinary collaboration, access to skilled personnel, advanced technical equipment and the financial possibilities of the workplace. Native CT examinations (PMCT) prior to autopsy are already a standard procedure in certain forensic departments in the Czech Republic (e.g., murders, suicides, deaths of children, traffic accidents etc.). Nonetheless, the progression of forensic sciences all over the world shows the necessity to integrate other advanced imaging modalities in routine forensic practice. Incorporating PMCTA into standard forensic workflows enhances the precision of forensic diagnostics, supplements traditional autopsy findings, and elevates the objectivity of forensic outputs. This paper presents technical notes on the development of PMCTA in forensic practice in a department that since 2015 until now has routinely performed native CT examinations. Institutional support was crucial in enabling the adoption of the imaging technique, which has so far been applied to more than thirty cases. The department is currently conducting a comparative study focused on the application of three different types of perfusion media - polyethylene glycol (PEG), saline, paraffin oil - and assessing the diagnostic efficacy of PMCTA relative to conventional autopsy. Based on our experience, PMCTA is suitable for all corpses except those with advanced post-mortem decomposition or extensive open injuries. The highest diagnostic yield is achieved in cases involving suspected gastrointestinal bleeding or vascular pathologies and lesions especially of large vessels (e.g., dissection/rupture of the aorta). The protocol for whole-body PMCTA can be adapted to meet the specific needs and conditions of individual forensic departments, providing a flexible yet robust framework for enhancing forensic medical investigations.

• Klíčová slova
• : post mortem computed tomography angiography (PMCTA), Autopsy, forensic pathology, post mortem computed tomography (PMCT), research, virtopsy,
• MeSH
• celotělové zobrazování * metody   MeSH
• CT angiografie * metody   MeSH
• lidé MeSH
• pitva metody   MeSH
• posmrtné zobrazování MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

This article describes a method of introducing postmortem CT angiography into daily forensic medicine practice involving cases of limb stab wounds investigated at the Department of Forensic Medicine, University Hospital Ostrava. The essential preparation of the vessels as well as practical tips facilitating the subsequent performance of a classic autopsy are described in detail. Article also includes brief review of published papers dealing with PMCT angiography related issues, advantages which brings CT angiography into forensic routine work, but also its limits and pitfalls.

• Klíčová slova
• Autopsy, forensic medicine, forensic pathology, forensic radiology, postmortem CT angiography, research, sharp force injuries,
• MeSH
• bodné rány * diagnostické zobrazování   MeSH
• CT angiografie * MeSH
• lidé MeSH
• pitva * metody   MeSH
• soudní lékařství metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Autopsies have played a crucial role in human medicine, forming a key foundation of medical knowledge. These final medical-anatomical procedures remain irreplaceable, shedding light on diagnoses, optimizing treatments, preventing disease spread, educating healthcare professionals, and influencing state jurisdiction. Despite the decline in the number of autopsies performed in recent decades, their medical-social significance remains essentially unchanged. Even today, autopsies contribute indispensably to the advancement of medicine and the benefit of society as a whole. Correspondence address: Veronika Rybárová, MD, PhD Department of Forensic Medicine and Medicolegal Expertise Jessenius Faculty of Medicine, Comenius University in Bratislava University Hospital Kollárova 2, 036 01 Martin, Slovak Republic tel.: +421434132770 e-mail: veronika.rybarova@uniba.sk Delivered: July 17, 2024 Accepted: August 17, 2024 * Toto je miesto kde sa smrť raduje pomáhajúc životu….

• Klíčová slova
• Autopsy, anatomical autopsy, clinical autopsy, forensic autopsy, history of autopsies, research, significance of autopsies,
• MeSH
• dějiny 18. století MeSH
• dějiny 19. století MeSH
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• lidé MeSH
• pitva * MeSH
• soudní lékařství dějiny   metody   MeSH
• Check Tag
• dějiny 18. století MeSH
• dějiny 19. století MeSH
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• historické články MeSH
• Geografické názvy
• Slovenská republika MeSH

This review article highlights the crucial role of organ weights and dimensions as key indicators in forensic diagnosis. Organ weight changes serve as valuable markers for pathological conditions, aiding forensic doctors in interpreting autopsy findings. The review emphasizes the importance of precision in establish- ing organ reference values, considering factors like population-specific norms and correlations with body parameters. Furthermore, it explores the impact of obesity on organ weights, emphasizing the need for updated databases that accurately reflect diverse populations. The article underscores the inadequacy of relying on outdated sources and advocates for creating a comprehensive and updated database of organ weights and dimensions for the local population, essential for accurate forensic interpretations.

• Klíčová slova
• obesity, organ dimensions, organ weights, reference databases,
• MeSH
• dospělí MeSH
• lidé MeSH
• pitva * MeSH
• referenční hodnoty MeSH
• velikost orgánu MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Drowning diagnosis is a complicated process in the autopsy, even with the assistance of autopsy imaging and the on-site information from where the body was found. Previous studies have developed well-performed deep learning (DL) models for drowning diagnosis. However, the validity of the DL models was not assessed, raising doubts about whether the learned features accurately represented the medical findings observed by human experts. In this paper, we assessed the medical validity of DL models that had achieved high classification performance for drowning diagnosis. This retrospective study included autopsy cases aged 8-91 years who underwent postmortem computed tomography between 2012 and 2021 (153 drowning and 160 non-drowning cases). We first trained three deep learning models from a previous work and generated saliency maps that highlight important features in the input. To assess the validity of models, pixel-level annotations were created by four radiological technologists and further quantitatively compared with the saliency maps. All the three models demonstrated high classification performance with areas under the receiver operating characteristic curves of 0.94, 0.97, and 0.98, respectively. On the other hand, the assessment results revealed unexpected inconsistency between annotations and models' saliency maps. In fact, each model had, respectively, around 30%, 40%, and 80% of irrelevant areas in the saliency maps, suggesting the predictions of the DL models might be unreliable. The result alerts us in the careful assessment of DL tools, even those with high classification performance.

• Klíčová slova
• Computer-aided diagnosis, Deep learning, Drowning, Postmortem computed tomography, Validity assessment,
• MeSH
• deep learning * MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pitva * metody   MeSH
• počítačová rentgenová tomografie * metody   MeSH
• posmrtné zobrazování MeSH
• reprodukovatelnost výsledků MeSH
• retrospektivní studie MeSH
• ROC křivka MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• utonutí * diagnóza   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

We report the forensic case of a 42-year-old man, a known drug user, who died at home and whose body was only discovered 2 months later. Autopsy was performed on a corpse in the late postmortem stage where no apparent cause of death was found. A toxicological screening of biological materials (blood, urine and gastric content) using liquid chromatography with different types of mass detection (ion trap and high-resolution) revealed the presence of methoxetamine (MXE), a ketamine analog, and its metabolites. MXE and a number of its metabolites (e.g., O-desmethyl, N-desethyl, hydroxy, glucuronides and sulfates) were identified in urine. Based on the results, a method using liquid chromatography with tandem mass spectrometry was developed and validated for the determination of MXE concentration in biological materials. The following values of MXE concentration were found: blood-3.6 ng/mL, urine-70.5 ng/mL and gastric content-18.0 ng/mL. Given the absence of other drugs, medications and poisons, it can be inferred that despite relatively low blood concentrations, MXE contributed to the victim's death. The present case demonstrates that even after 2 months, MXE and its several metabolites can be detected and determined in the human cadaver at a relatively advanced stage of decomposition.

• MeSH
• cyklohexanony * analýza   metabolismus   MeSH
• cyklohexylaminy * MeSH
• dospělí MeSH
• lidé MeSH
• mrtvola MeSH
• pitva MeSH
• tělesné tekutiny * metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• 2-(3-methoxyphenyl)-2-(ethylamino)cyclohexanone MeSH Prohlížeč
• cyklohexanony * MeSH
• cyklohexylaminy * MeSH

OBJECTIVE: This study evaluates a case of pseudopathology and the effects that postmortem taphonomic changes and environmental influences can have on bone. MATERIAL: A skeleton of a young male from the early medieval site Staré Město, dated to the 9th-10th century CE. METHODS: The skeletal remains were subjected to detailed macroscopic and X-ray examination, and then a CT scan and XRF analysis were performed. RESULTS: X-ray examination of the mandible revealed unusually dense structures, whose appearance was not consistent with any known pathology. Based on the results of CT scanning, it was hypothesized that these were cavities filled with alluvial sediment. X-ray fluorescence spectrometry (XRF), focusing on the determination of the silica content, revealed a high intensity of silica in the samples of the affected area of the bone. CONCLUSION: The hypothesis that the inclusions were composed of waterborne sediment was supported. SIGNIFICANCE: Although it is well known that soil can infiltrate bones buried in the ground, its appearance on plain radiographs is not that commonly known. The case illustrates the usefulness of differentiating true pathologies from postmortem alterations to avoid inappropriate interpretations. LIMITATIONS: No similar cases have been described. SUGGESTION FOR FURTHER RESEARCH: In palaeopathological evaluation, the use of multiple imaging and evaluative techniques should be implemented to differentiate pathological lesions from pseudopathology.

• Klíčová slova
• Computer tomography (CT), Pseudopathology, Radiography, Soil inclusion, Taphonomy, X-ray fluorescence spectrometry (XRF),
• MeSH
• artefakty * MeSH
• lidé MeSH
• mandibula MeSH
• oxid křemičitý MeSH
• pitva MeSH
• posmrtné změny * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• oxid křemičitý MeSH

• MeSH
• exsanguinace * etiologie   MeSH
• lidé MeSH
• pitva MeSH
• sebevražda * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• komentáře MeSH

Sudden cardiac death (SCD) in individuals younger than 40 years has a heritable cause in a significant part of the cases. Identification of SCD, post mortem genetic analysis, and the cardiological screening examination in victim´s relatives represent an important diagnostic tool for the primary prevention of cardiac arrest. Based on global and European recommendations, cases of sudden cardiac death in individuals under the age of 40 with negative or ambiguous autopsy findings, or findings suspicious for hereditary cardiovascular disease, should be investigated using molecular genetic methods. Based on European guidelines, the Czech Society of Forensic Medicine and Forensic Toxicology has developed its own recommended procedure, which summarizes the identification of these cases, the optimal autopsy procedure, including the collection of material, and a summary of other necessary actions for performing a post mortem genetic examination in a person who has died suddenly. Complex examination of these cases requires multicentric and multidisciplinary collaboration.

• Klíčová slova
• guidelines, inherited cardiovascular diseases, post mortem genetic analysis, prevention, sudden cardiac death, treatment,
• MeSH
• dospělí MeSH
• genetické testování MeSH
• lidé MeSH
• náhlá srdeční smrt * etiologie   MeSH
• pitva metody   MeSH
• soudní lékařství * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Sudden cardiac death (SCD) might have an inherited cardiac condition background. Genetic testing supports post-mortem diagnosis and screening of relatives at risk. Our aim is to determine the feasibility of a Czech national collaboration group and to establish the clinical importance of molecular autopsy and family screening. From 2016 to 2021, we have evaluated 100 unrelated SCD cases (71.0% males, age: 33.3 (12.8) years). Genetic testing was performed by next-generation sequencing utilizing a panel of 100 genes related to inherited cardiac/aortic conditions and/or whole exome sequencing. According to autopsy, cases were divided into cardiomyopathies, sudden arrhythmic death syndrome, sudden unexplained death syndrome, and sudden aortic death. We identified pathogenic/likely pathogenic variants following ACMG/AMP recommendations in 22/100 (22.0%) of cases. Since poor DNA quality, we have performed indirect DNA testing in affected relatives or in healthy parents reaching a diagnostic genetic yield of 11/24 (45.8%) and 1/10 (10.0%), respectively. Cardiological and genetic screening disclose 83/301 (27.6%) relatives at risk of SCD. Genetic testing in affected relatives as starting material leads to a high diagnostic yield offering a valuable alternative when suitable material is not available. This is the first multidisciplinary/multicenter molecular autopsy study in the Czech Republic which supports the establishment of this type of diagnostic tests. A central coordinator and proper communication among centers are crucial for the success of a collaboration at a national level.

• Klíčová slova
• Forensic genetics, Inherited cardiovascular diseases, Molecular autopsy, Sudden cardiovascular death, Sudden death prevention,
• MeSH
• dospělí MeSH
• genetické testování * MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhlá srdeční smrt * etiologie   MeSH
• pilotní projekty MeSH
• pitva * MeSH
• studie proveditelnosti MeSH
• vysoce účinné nukleotidové sekvenování MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH