Abstract：
Child abuse is a serious concern that can cause the death of a child. In such cases the medico-legal evidence is often pivotal but complex, drawing across multiple medical disciplines and techniques. One key specialism is histopathology, which is considered the gold standard for estimating the age of individual fractures. Another is micro-CT imaging, which can visualise the location of trauma across the body. This case report demonstrates how micro-CT was used to contextualise the histological evidence in the Criminal Justice Proceedings of a fatal child abuse case. This was achieved by overlaying the aged fracture evidence from histopathology onto the visuals rendered from micro-CT imaging. The case was a suspected child abuse of a deceased 1-month old infant who was reported unresponsive by their parents. The child was taken to hospital where they were pronounced dead. Suspicion was raised and post-mortem imaging confirmed head trauma and rib fractures, and the case was escalated for a forensic investigation. This case report details how the micro-CT imaging was merged with the gold standard of histopathology for visualisation of trauma, and how the court presentation was planned alongside Senior Investigating Officers and various medical experts. The presentation was used in court by the histopathologist to present the evidence. The resulting presentation provided additional clarity to jury members regarding the location, severity, frequency, and timings of the injuries. From the perspective of the investigating police force, the resulting presentation was crucial in ensuring understanding of the medico-legal evidence of how the infant died. The prosecuting lawyer noted that combining the histological and micro-CT evidence in this way allowed the evidence to be presented in a sensitive, clear, and impactful manner.
摘要：
虐待儿童是一个严重的问题，可能导致儿童死亡。在这种情况下，医学法律证据通常是关键但复杂的，跨越多个医学学科和技术。一个关键的专业是组织病理学，这被认为是估计个体骨折年龄的黄金标准。另一种是显微CT成像，可以看到整个身体创伤的位置。此案例报告演示了如何在致命的虐待儿童案件的刑事司法程序中使用micro-CT对组织学证据进行背景分析。这是通过将组织病理学的老年骨折证据叠加到显微CT成像的视觉效果上来实现的。此案涉嫌虐待一名1个月大的婴儿，据其父母报告该婴儿没有反应。孩子被送往医院，被宣布死亡。怀疑增加，死后成像证实头部创伤和肋骨骨折，案件被升级为法医调查。该病例报告详细介绍了显微CT成像如何与组织病理学的黄金标准合并以可视化创伤。以及如何与高级调查官员和各种医学专家一起计划法庭陈述。组织病理学家在法庭上使用该演示文稿来提供证据。由此产生的陈述为陪审团成员提供了关于位置的更清晰的信息，严重程度,频率,和受伤的时间。从调查警察的角度来看，由此产生的陈述对于确保理解婴儿死亡的医学法律证据至关重要.起诉律师指出，以这种方式结合组织学和显微CT证据可以使证据以敏感的方式呈现，clear,和有影响力的方式。
