Introduction Due to space limitations, and in an attempt to cond...

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Introduction

Due to space limitations, and in an attempt to conduct an in-depth analysis, this paper restricts its focus to the role of PM-MR (PM-MR) in investigation of non-accidental injuries (NAI) in infants and children. As will be seen, the paper’s aim is to demonstrate how the prospective efficacy of PM-MR in NAI investigations cannot be extricated from the underlying and controversial difficulties in ascribing observed injuries—such as subdural hemorrhages (SDH) and hypoxic-ischemic encephalopathy (HIE)—to NAI such as shaken baby syndrome (SBS). Also discussed will be how PM-MR limitations happen to conspire with those difficulties of ascription to further confound the prospects of MRI-centered post-mortem investigation of NAI.

Prior to commencing this analysis, an explanation should be provided for why consideration of CT in this context has been set aside to maximize focus on PM-MR. A primary reason is that, while CT has the advantages of availability, relatively rapid imaging times, and value as an initial step in assessing SDH due to suspected NAI in infants and children, MRI is the follow-up method of choice due to its ability to provide, for example, full appraisal of SDH (Hedlund, 2012). Besides, as Hedlund (2012) notes for pediatric centers such as his, MRI is triggered regardless of preliminary CT findings for cases in which there are signs of abuse such as extracranial injuries.

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Introduction
Due to space limitations, and in an attempt to conduct an in-depth analysis, this paper restricts its focus to the role of post-mortem MRI in investigation of non-accidental injuries (NAI) in infants and children. As will be seen, the paper’s aim is to demonstrate how the prospective efficacy of post-mortem MRI in NAI investigations cannot be extricated from the underlying and controversial difficulties in ascribing observed injuries—such as subdural hemorrhages (SDH) and hypoxic-ischemic encephalopathy (HIE)—to NAI such as shaken baby syndrome (SBS). Also discussed will be how MRI limitations happen to conspire with those difficulties of ascription to further confound the prospects of MRI-centered post-mortem investigation of NAI.
To begin, a methodologically-robust prospective validation study lays the groundwork, both for the potential of post-mortem MRI as part of increasingly in-demand minimally invasive autopsies and for the limitations of MRI, such as in the detection of infections and ante-mortem hypoxic-ischemic injury....

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