{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:25:03Z","timestamp":1791617103012,"version":"4.3.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bern"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To assess the accuracy of CT and MRI reports of alert patients presenting after non-self-inflicted strangulation (NSIS) and evaluate the appropriateness of these imaging modalities in NSIS.<\/jats:p>\n <\/jats:sec>\n \n Material and methods<\/jats:title>\n The study was a retrospective analysis of patient characteristics and strangulation details, with a comparison of original radiology reports (ORR) to expert read-outs (EXR) of CT and MRI studies of all NSIS cases seen from 2008 to 2020 at a single centre.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study included 116 patients (71% women,\n p\u00a0<\/jats:italic>\n < .001,\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n ), with an average age of 33.8 years, mostly presenting after manual strangulation (97%). Most had experienced intimate partner violence (74% of women,\n p\u00a0<\/jats:italic>\n < .001,\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n ) or assault by unknown offender (88% of men,\n p\u00a0<\/jats:italic>\n < 0.002\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n ). Overall, 132 imaging studies (67 CT, 51% and 65 MRI, 49%) were reviewed. Potentially dangerous injuries were present in 7%, minor injuries in 22%, and no injuries in 71% of patients. Sensitivity and specificity of ORR were 78% and 97% for MRI and 30% and 98% for CT. Discrepancies between ORR and EXR occurred in 18% of all patients, or 62% of injured patients, with a substantial number of unreported injuries on CT.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The results indicate that MRI is more appropriate than CT for alert patients presenting after non-self-inflicted strangulation and underline the need for radiologists with specialist knowledge to report these cases\u00a0in order to add value to both patient care and potential future medico-legal investigations.<\/jats:p>\n <\/jats:sec>\n \n Clinical relevance statement<\/jats:title>\n MRI should be preferred over CT for the investigation of strangulation related injuries in alert patients because MRI has a higher accuracy than CT and does not expose this usually young patient population to ionizing radiation.<\/jats:p>\n <\/jats:sec>\n \n Key Points<\/jats:title>\n \n \u2022 Patients presenting after strangulation are often young women with a history of intimate partner violence while men typically present after assault by an unknown offender.<\/jats:italic>\n <\/jats:p>\n \n \u2022 Expert read-outs of CT and MRI revealed potentially dangerous injuries in one of 14 patients.<\/jats:italic>\n <\/jats:p>\n \n \u2022 MRI has a significantly higher sensitivity than CT and appears to be more appropriate for the diagnostic workup of alert patients after strangulation.<\/jats:italic>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1007\/s00330-023-10354-3","type":"journal-article","created":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T23:09:17Z","timestamp":1699830557000},"page":"3813-3822","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Imaging of alert patients after non-self-inflicted strangulation: MRI is superior to CT"],"prefix":"10.1007","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-9143","authenticated-orcid":false,"given":"Thomas D","family":"Ruder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Gonzenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Heimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Arneberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Klukowska-R\u00f6tzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Blunier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristomenis K","family":"Exadaktylos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-Dieter","family":"Zech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franca","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,13]]},"reference":[{"key":"10354_CR1","doi-asserted-by":"publisher","first-page":"3458","DOI":"10.1007\/s00330-019-06033-x","volume":"29","author":"J Heimer","year":"2019","unstructured":"Heimer J, Tappero C, Gascho D et al (2019) Value of 3T craniocervical magnetic resonance imaging following nonfatal strangulation. 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However, no complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained. Approval (ref. b2019-00406) was given by the Ethics Committee of the Canton of Bern (Kantonale Ethikommission Bern) which is part of the Swiss Association of Research Ethics Committees (swissethics.ch).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Some study subjects have been previously reported in: Hostettler-Blunier S, Raoussi A, Johann S, Ricklin M, Klukowska-R\u00f6tzler J, Utiger S, Exadaktylos A, Brodmann Maeder M. Domestic Violence at the University Emergency Department Bern: A Retrospective Analysis from 2006 to 2016. Praxis<\/i> 2018; 107: 886\u2013892\n \n .","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"value":"\u2022 retrospective\u2022 observational study\u2022 performed at one institution","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}