[Combination of imaging studies and autopsy in death investigations].

The progress in quality and availability of imaging studies has made them an invaluable part of the clinical diagnostic process, so much so that the forensic medical community had to acknowledge their importance and to implement them in death investigations. Since 2011 roughly 200 post-mortem radiographic examinations were conducted, mostly followed by full autopsies. Four of those cases are given as an example of the benefits and limitations of these methods. A review of the literature and our experience so far, show that computed tomography provides better visualization and 3D reconstruction of traumatic bone injuries, as well as good assessment of air in the tissues and vascular system, gunshot wound tracts, and anthropological characteristics for identification. Imaging methods are relatively limited in definite diagnostic findings in cases of sudden death from natural causes, such as pneumonia, pulmonary embolism, acute myocardial infarction or meningitis, problems which can be partially solved with the aid of angiographic studies. These methods also do not allow for sampling of tissues for microscopic examination, nor fluid samples for cultures and toxicology. In the current cultural and social reality in Israel, imaging studies enable minimization of the autopsy and, in certain cases, its relinquishment serves as a compromise between the necessity of death investigation and beliefs in the wholeness of the body. In light of the advantages of imaging, no autopsy of a trauma-related death can be complete without it.