This research project had the goal of correlating magnetic resonance imaging biomarkers with histopathologic findings in the brain, and identifying unique regions of interest that have previously not been routinely investigated, such as cortical structures.
The authors of this research report had the goal of correlating magnetic resonance imaging (MRI) biomarkers including advanced diffusion techniques, such as diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) in fatal homicidal pediatric blunt head injuries, with histopathologic findings in the brain. The authors also aimed to identify unique regions of interest that have previously not been routinely investigated, such as cortical structures. Their two central research questions were to determine the following: if MRIs enable forensic pathologists to characterize inflicted head injuries better and focus histologic evaluations; and if advanced imaging identifies additional areas of injury that are not typically targeted by routine neuropathologic examination. The research hypothesis was as follows: the use of MRI imaging in pediatric homicidal blunt traumatic brain injury will supplement the neuropathologic evaluation of traumatic axonal injury and provide additional information useful to the pathologist and criminal justice system. The research study was divided into two phases, with certain cases meeting criteria to undergo a third phase of study: phase one involved collecting cases that met the established inclusion criteria, performing advanced computed tomography (CT) and magnetic resonance (MR) imaging and comprehensive neuropathologic evaluation; phase two involved evaluating the accuracy of MR imaging interpretation compared to the histologic evaluation, and determining whether the difference is statistically significant. The authors reported several complications that prevented the accomplishment of the research project’s goals, however a major accomplishment was the design of a brain holder that adjusts for holding each brain in place, so that scanning may be performed without motion artifact, and 3-dimensional (3D) printing allows for inexpensive rapid prototyping, where designs can be quickly refined and printed.