An evaluation of the objectivity and reproducibility of shear wave elastography in estimating the post-mortem interval: a tissue biomechanical perspective

Cadaveric rigidity—also referred to as rigor mortis —is a valuable source of information for estimating the time of death, which is a fundamental and challenging task in forensic sciences. Despite its relevance, assessing the level of cadaveric rigidity still relies on qualitative and often subjective observations, and the development of a more quantitative approach is highly demanded. In this context, ultrasound shear wave elastography (US SWE) appears to be a particularly well-suited technique for grading cadaveric rigidity, as it allows non-invasive quantification of muscle stiffness in terms of Young’s modulus ( E ), which is a widely used parameter in tissue biomechanics. In this pilot study, we measured, for the first time in the literature, changes in the mechanical response of muscular tissues from 0 to 60 h post-mortem (hpm) using SWE, with the aim of investigating its applicability to forensic practice. For this purpose, 26 corpses were included in the study, and the muscle mechanical response was measured at random times in the 0–60 hpm range. Despite the preliminary nature of this study, our data indicate a promising role of SWE in the quantitative determination of cadaveric rigidity, which is still currently based on qualitative and semiquantitative methods. A more in-depth study is required to confirm SWE applicability in this field in order to overcome some of the inherent limitations of the present work, such as the rather low number of cases and the non-systematic approach of the measurements.

[1]  L. Atzori,et al.  A Metabolomic Approach to Animal Vitreous Humor Topographical Composition: A Pilot Study , 2014, PloS one.

[2]  M. Papi,et al.  Dynamic structural determinants underlie the neurotoxicity of the N-terminal tau 26-44 peptide in Alzheimer's disease and other human tauopathies. , 2019, International journal of biological macromolecules.

[3]  Sabrina S. M. Lee,et al.  Use of shear wave ultrasound elastography to quantify muscle properties in cerebral palsy. , 2016, Clinical biomechanics.

[4]  Subra Suresh,et al.  Biomechanics and biophysics of cancer cells. , 2007, Acta biomaterialia.

[5]  M. Papi,et al.  Nanoscale mechanics of brain abscess: An atomic force microscopy study. , 2018, Micron.

[6]  B Madea,et al.  Estimation of the time since death in the early post-mortem period. , 1995, Forensic science international.

[7]  C. Henßgea,et al.  Estimation of the time since death in the early post-mortem period , 2004 .

[8]  A. Vain,et al.  Grading rigor mortis with myotonometry--a new possibility to estimate time of death. , 1992, Forensic science international.

[9]  G. Vallone,et al.  Use of ultrasound shear wave to measure muscle stiffness in children with cerebral palsy , 2018, Journal of Ultrasound.

[10]  Jeong Hyun Lee,et al.  Ultrasound elastography for evaluation of cervical lymph nodes , 2015, Ultrasonography.

[11]  F. Monticelli,et al.  Postmortem muscle protein degradation in humans as a tool for PMI delimitation , 2016, International Journal of Legal Medicine.

[12]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[13]  Jean-Baptiste Pialat,et al.  Ultrasound elastography in tendon pathology: state of the art , 2017, Skeletal Radiology.

[14]  V. Pascali,et al.  A novel method for post-mortem interval estimation based on tissue nano-mechanics , 2019, International Journal of Legal Medicine.

[15]  Emanuela Locci,et al.  Monitoring the Modifications of the Vitreous Humor Metabolite Profile after Death: An Animal Model , 2015, BioMed research international.

[16]  M. Papi,et al.  Nanomechanical mapping helps explain differences in outcomes of eye microsurgery: A comparative study of macular pathologies , 2019, PloS one.

[17]  F. Calliada,et al.  Median nerve evaluation by shear wave elastosonography: impact of “bone-proximity” hardening artifacts and inter-observer agreement , 2017, Journal of Ultrasound.

[18]  Terry K Koo,et al.  A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. , 2016, Journal Chiropractic Medicine.

[19]  Burkhard Madea,et al.  Methods for determining time of death , 2016, Forensic Science, Medicine, and Pathology.

[20]  Ueli Aebi,et al.  The nanomechanical signature of breast cancer. , 2012, Nature nanotechnology.

[21]  Valentina Palmieri,et al.  A fully-automated neural network analysis of AFM force-distance curves for cancer tissue diagnosis , 2017 .

[22]  Marco De Spirito,et al.  Changes in cellular mechanical properties during onset or progression of colorectal cancer. , 2016, World journal of gastroenterology.

[23]  E. d’Aloja,et al.  Morphological analysis of corneal findings modifications after death: A preliminary OCT study on an animal model , 2018, Experimental eye research.

[24]  F. Conti,et al.  Point quantification elastography in the evaluation of liver elasticity in healthy volunteers: a reliability study based on operator expertise , 2018, Journal of Ultrasound.

[25]  Valentina Palmieri,et al.  E ffi cient Spatial Sampling for AFM-Based Cancer Diagnostics: A Comparison between Neural Networks and Conventional Data Analysis , 2019 .

[26]  Dmitri D. Pervouchine,et al.  The effects of death and post-mortem cold ischemia on human tissue transcriptomes , 2018, Nature Communications.

[27]  Marco De Spirito,et al.  Nano-mechanical signature of brain tumours. , 2016, Nanoscale.

[28]  Estimation of the breaking of rigor mortis by myotonometry. , 1996, Forensic science international.

[29]  Z. Bayramoğlu,et al.  Evaluation of parotid glands in healthy children and adolescents using shear wave elastography and superb microvascular imaging , 2018, La radiologia medica.

[30]  Matteo Stocchero,et al.  A 1H NMR metabolomic approach for the estimation of the time since death using aqueous humour: an animal model , 2019, Metabolomics.

[31]  A. Pichiecchio,et al.  Muscle ultrasound elastography and MRI in preschool children with Duchenne muscular dystrophy , 2018, Neuromuscular Disorders.

[32]  Agostinho Santos,et al.  Necromechanics: Death-induced changes in the mechanical properties of human tissues , 2015, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[33]  W. Jeong,et al.  Shear-wave elastography: a noninvasive tool for monitoring changing hepatic venous pressure gradients in patients with cirrhosis. , 2014, Radiology.

[34]  O. Hélénon,et al.  Reprint of "Update on ultrasound elastography: Miscellanea. Prostate, testicle, musculo-skeletal". , 2014, European journal of radiology.

[35]  O. Hélénon,et al.  Update on ultrasound elastography: miscellanea. Prostate, testicle, musculo-skeletal. , 2013, European journal of radiology.

[36]  Gérard Forzy,et al.  Factors of accuracy of transient elastography (fibroscan) for the diagnosis of liver fibrosis in chronic hepatitis C , 2009, Hepatology.

[37]  F. Piscaglia,et al.  Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actors on the Stage , 2016, Ultraschall in der Medizin.

[38]  F. Calliada,et al.  Influence of subjects’ characteristics and technical variables on muscle stiffness measured by shear wave elastosonography , 2017, Journal of Ultrasound.

[39]  C. R. Ethier,et al.  Introductory Biomechanics: From Cells to Organisms , 2007 .

[40]  Ence Yang,et al.  Systematic analysis of gene expression patterns associated with postmortem interval in human tissues , 2017, Scientific Reports.

[41]  Yi Cao,et al.  The nanomechanical signature of liver cancer tissues and its molecular origin. , 2015, Nanoscale.

[42]  S. Chizhik,et al.  Atomic force microscopy probing of cell elasticity. , 2007, Micron.

[43]  M. Papi,et al.  Mapping viscoelastic properties of healthy and pathological red blood cells at the nanoscale level. , 2015, Nanoscale.