MUMMIES / LES MOMIES
Diagnostic paleoradiology of mummified tissue:
interpretation and pitfalls
Frank J. Rühli, Dr. med., PhD; Rethy K. Chhem, MD, PhD, FRCPC; Thomas Böni, MD
D
ead human and animal tissue can, because of natural conditions or
artificial attempts, escape postmortem decay partially or even completely. This process called “mummification” derives linguistically from
the Persian word mum or mom, which means beeswax.1 In order to conduct an accurate radiologic diagnosis of the anatomical and pathologic
changes in mummies, and thereby advance research in this area, a thorough knowledge of the process of mummification itself is required. The
purpose of this article is to review the role of diagnostic paleoradiology in
mummy studies.
Natural mummification may occur under contrasting climatic conditions:
the alpine/arctic process of freeze-drying, which requires sufficient air flow
to sublimate body water; preservation in northern European peat bogs, in
which acids interfere with enzymatic soft-tissue decomposition; or the
mummification that can happen in the hot and arid environment of deserts.
Artificial mummification can be achieved by embalming a body, as
seen in the funerary tradition of Ancient Egypt where a physically wellpreserved body was essential to gain immortality. Surprisingly, this
method has been described very rarely in historical times and is passed
on to us de facto only by Herodotus of Halicarnassus (fifth century BC)
and by Diodorus Siculus (first century BC). Essentially, it involved the
complete or incomplete removal of the internal organs using diverse
tools.2 Desiccation of the body was obtained by using natron,3,4 a blend of
NaCl, Na2CO3, NaHCO3 and NaP2SO4.5 The term “natron” was coined after
the Wadi Natrun region in Egypt. The embalming substance was a still
mostly unknown mixture of natron with various preserving and aromatic
products.6–12 Finally, the corpse was wrapped with bandages and kept
within a coffin in a well-sealed tomb. Since antiquity, the presence of
valuable burial goods, such as jewellery and religious objects, in Egyptian
tombs has attracted many thieves. Mummies recovered in modern times
usually bear several stigmata of these acts of vandalism caused by tomb
looters. Burial artifacts have also been removed during archaeological excavations and the scientific unwrapping of mummies. Mysterious deaths
of scientists have been linked with the “curse of the Pharaohs,” a romantic speculation without any strong scientific basis.13
Postmortem alterations of soft tissues and bone caused by artificial
mummification are numerous. Internal organs were either removed completely and kept in jars or were put back in the abdominal cavity after being embalmed separately. The latter were also called “organ packages” to
differentiate them from packed rolls of bandage that were used to fill the
empty body cavities. Rarely, bones were macerated and the soft tissue remodelled using layers of mud.14 During the 21st dynasty (ca. 1000 BC) in
Ancient Egypt, the skin was incised at various locations and layers of
mud were inserted subcutaneously to make the skin appear livelier. Often, the brain was removed through the ethmoidal cells and cribriform
218
JACR VOL. 55, No 4, OCTOBRE 2004
Rühli, Böni — Clinical Paleopathology
Team, Orthopedic University Clinic
Balgrist and Institute for the History of
Medicine, University of Zurich; Rühli —
Institute of Anatomy, University of Zurich,
Zurich, Switzerland; Chhem — Paleoradiology Research Unit, Department of
Radiology, London Health Sciences
Centre, University of Western Ontario,
London, Ont.
Address for correspondence: Dr. Frank J.
Rühli, Institute of Anatomy, University of
Zurich, Winterthurerstrasse 190, 8057
Zurich, Switzerland; fax 4116355702;
[email protected]
Submitted Mar. 1, 2004
Accepted May 19, 2004
Can Assoc Radiol J 2004;55(4):218-27.
© 2004 Canadian Association of Radiologists
PALEORADIOLOGY OF MUMMIFIED TISSUE
plates,15,16 without clear preference for a particular nostril side.17
All organs of human bodies are significantly altered
because of the taphonomic processes observed in
mummification. The skin usually loosens from the
epidermis. Body hair is rare,18 because it may have
been shaved at the beginning of the embalming
process. In the naturally frozen mummies of the High
Andes, postmortem alterations have been recently
evaluated in some detail by Previgliano et al19,20 using a
nonhelical computed tomography (CT) scanner. These
authors showed a decrease in size of soft-tissue compartments resulting from the loss of water during the
natural process of mummification. However, the overall state of preservation of these bodies remains excellent and allows an accurate identification of internal
organs and soft-tissue pathologies.
Finally, experimental mummification of human4,21
and animal remains22,23 has been performed in modern
times as well, generally showing radiologic and
anatomical features comparable to those demonstrated
in authentic ancient mummies.
RADIOLOGIC INVESTIGATION OF MUMMIES
The earliest radiologic examinations of mummies
were performed by Koenig,24 Holland25 and Dedekind,26
within a few months of the discovery of x-rays by
Roentgen,27 and later by Petrie.28
Conventional radiologic assessment of mummies
has been an established diagnostic tool for decades.29
The technical protocol and parameters used in conventional radiographic studies of mummies have been
described before.6,20,30,31 Furthermore, CT has been used
as an adjunctive, noninvasive modality to radiography
for the investigation of mummies, including the establishing of the presence of bones within a wrapped
bundle32 or the identification of embalming artifacts
inserted during the wrapping process.33,34 The respective role of conventional radiography, CT and magnetic resonance imaging (MRI) for fossil studies, in
particular, has also been reviewed.35 Finally, the value
of CT in the clinical assessment of skeletal pathologies
in the modern population has been well established.36
The method of interpretation of radiologic features
for detecting diseases in modern clinical situations has
often been applied to the diagnosis of paleodiseases. Radiopathologic findings in clinical situations should be
compared with those in ancient tissues with extreme
caution, because the features of contemporary disease
may have been altered by modern treatment such as antibiotics, steroids, radiation therapy or chemotherapy.
Furthermore, ancient remains may show conditions
that are no longer present and known in our times.
To increase the accuracy with which paleopathologic conditions can be detected and, therefore, to
minimize diagnostic errors, the images should be
preferably acquired, analyzed and interpreted by experienced radiologists in collaboration with either a
physical anthropologist or a pathologist specialized in
the study of ancient remains. The best method with
which to approach the investigation of ancient skeletal
remains would be similar to that of a clinical “tumour
board” where a skeletal radiologist, orthopedic surgeon and bone pathologist meet to discuss radiologic
and pathologic findings.
Most of all, there is still no acceptable reference standard for paleopathologic diagnosis. Yet, conventional
radiography remains the essential foundation of the diagnosis of disease in mummies. It has many advantages,
including wide availability, easy access, low cost and,
most important, high spatial resolution. Unfortunately,
its low contrast resolution may sometimes prevent the
researcher from making an accurate distinction between
mummified soft tissue and embalming artifacts. The
superimposition of various body parts because of a
mummy’s positioning37 and the presence of wooden
coffins (Fig. 1), wrapping materials, embalming substances and radio-opaque amulets represent major limitations for an adequate interpretation of the x-ray films
because of the artifacts they create (Fig. 2).6,30 Fluoroscopy and spot radiographs have also been used as
screening tests for possible imaging pitfalls in the initial
investigation of mummies.30 With the use of digital
FIG. 1: Conventional radiograph (dorsoplantar direction from
inside the coffin) of the feet of an Ancient Egyptian mummy (ca.
300 BC ; Naturwissenschaftliche Sammlungen, Winterthur,
Switzerland) with radio-opaque artifacts resulting from the presence of nails and lead-based colour paintings on a modern sarcophagus (Post-Napoleonic Egyptomania style, late 18 th to
early 19th century AD).
CARJ VOL. 55, NO. 4, OCTOBER 2004
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radiography, as recently introduced in clinical practice,
some of these pitfalls may not be a problem any more.
CT easily suppresses superimposition. Its ability to
measure the densities of mummified tissues may bring
additional information about diseases, the embalming
process and other postmortem alterations (Table 1).6,38–44
The radiologic investigation of the approximately
5300-year-old Copper Age natural mummy called the
“Iceman from Tyrol” shows how much imaging contributes to the diagnosis of paleopathologies.45–47 In that
case, diagnostic paleoradiology detected healed rib
fractures; premortem stress markers (e.g., Harris lines);
arteriosclerosis, as reported in other mummies;34,48–53
and anatomical variations such as bilateral absence of
ribs, osteoarthritis of feet, an arrowhead in the left
shoulder region and postmortem skeletal changes.
There are numerous potential radiologic pitfalls when
investigating Egyptian mummies. The process of embalming leads to some typical alterations that can be
detected on CT. Postmortem dehydration and decomposition produces irregular folded skin appearing as
multiple layers of dry, soft tissues, separated by air
pockets. Furthermore, in some cases, soft tissues are
more radio-opaque,5 possibly because of shrinkage and
deposition of embalming materials/wrappings. Therefore, the differentiation of a mummy’s abdominal organs can be very difficult.37 The matrix between the
bone trabeculae is often replaced by air, therefore becoming more radiolucent, whereas shrunken parenchymatous organs turn more radiodense.39 By comparing
an initial CT examination and one performed 2 years
later, Murphy et al47 showed a change in trabecular
bone feature and density, with a different pattern of airspace distribution in the medullar cavity. It is not clear
whether this phenomenon was induced by an air–ice
exchange during the taphonomic process or not.
Mummies’ brains can display a varied degree of
preservation, as shown in conventional x-ray films of
bodies that have been preserved in peat bogs.54 When a
brain is still left in situ, it is sometimes, but not always, possible to differentiate grey matter from white
matter on computed tomographic images.19,20,47,55,56 The
presence of residual meningeal linings has been interpreted as an evidence for the lack of an attempt to remove the brain post mortem in such an individual.17
However, these meningeal layers can be found even
when the brain is completely removed and, therefore,
should not be used as an indicator for brain preservation (Fig. 3).33 Those intracranial artifacts may simulate
authentic lesions, and awareness of these problems is
of the utmost importance to prevent a wrong diagnosis
of cerebral pathologies in mummies.
A
B
DIAGNOSTIC PALEORADIOLOGY: RADIOLOGIC FEATURES,
PATHOLOGIC ANATOMY AND ARTIFACTS
FIG. 2: Conventional anteroposterior radiograph (left) and computed tomographic (CT) image (right) of the abdominal region of an Egyptian mummy (ca. 900 BC; Musée d’ethnographie, Neuchâtel, Switzerland; CT data: Somatom HiQ scanner [Siemens, Erlangen, Germany],
133 kV, 120 mA) show multiple opacities, representing embalming substances, intra-abdominal stuffing and wrapping materials.
220
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PALEORADIOLOGY OF MUMMIFIED TISSUE
Postmortem alterations of the anatomy of the chest
and collapsed lungs make radiologic interpretation in
mummy studies often extremely difficult, as seen in
the Iceman mummy where snow and ice pressure led
to a severe anteroposterior collapse of the entire thorax.47 In another case, a diagnosis of air-inflated lung
tissue was suggested by CT, but autopsy showed
frozen pleural fluid as part of a hemopneumothorax.52
In the same study, radio-opaque masses located in the
left side of the abdominal cavity were coprolites and
not “organ packages,” as confirmed by autopsy of the
corpse. Postmortem fractures are commonly seen in
the pelvic girdle and the spine. Rib fractures may be
caused by postmortem trauma caused by excessive
wrapping with bandages of an Egyptian mummy.51 It is
not unusual to identify vertebrae51 or teeth in a wrong
anatomical location in Ancient Egyptian mummies.6
Intervertebral disc spaces are smaller30,47 in mummies because of desiccation. They may contain air as a
result of the postmortem alterations6 and, in some instances, ochronosis-like pigmentation may occur. In
contrast to earlier claims of possible alkaptonuria,57
Walgren et al58 used MRI spectroscopy to confirm that
substance deposition in intervertebral discs was instead most probably induced by the embalming
process itself. Braunstein et al59 reported chondrocalcinosis of intervertebral disc and menisci as a possible
embalming artifact. Finally, for Gray,60 the calcification
of the intervertebral disc in mummies is the result of
natron deposition within the intervertebral disc.
Embalming substances can be found all over a
mummy’s body, especially in the anatomical cavities,
mainly the thorax, abdomen, external auditory canal
and orbits. Resin, in particular, has been identified in
bone61 and joints.62
FIG. 3: CT image shows an empty mummy skull (ca. 900 BC;
Musée d’ethnographie, Neuchâtel, Switzerland; CT data: Somatom HiQ scanner [Siemens], 133 kV, 120 mA) with dura
mater remains, which are especially visible as they are attached
at the tabula interna on the right temporal side, despite obvious
postmortem removal of the brain through the left ethmoid region.
There are deposits of residual high-density embalming substance
in the middle. Bilateral eye-like decorations are visible.
Table 1: Density* of mummification-related structures established by computed tomography
Structure
Lung
Various bones (some areas with an air-filled
matrix of spongiosa)
Density, Hounsfield units (HU)
–920
–638 to 953
Reference
Sigmund and Minas38
Rühli6
Ocular bulb filling
–600
Sigmund and Minas38
Air-filled artificial subcutaneous space
–543
Rühli6
Soil (subcutaneous stuffing material)
–150
Hübener and Pahl39
Beeswax
–140
Hübener and Pahl39
Ointment–oil
40
Germer et al40
Resin-like fluid
71
Sigmund and Minas38
Various embalming materials (grains/solid)
Artificial eye (various materials)
Plaster
Ceramic toe prosthesis
Gold
430/773/1148/1427
523/525/2251/2346/2422
1000
–600 to 1318
> 1500
Soto-Heim et al41
Baldock et al5
Hübener and Pahl39
Wagle42
Hübener and Pahl39
Amulet
1600
Sigmund and Minas38
Calcium carbonate repair
1828
Rühli,6 Rühli and Böni43
Heart scarab†
2410
Jansen et al44
*Reference HU values: air, –1000 HU; water, 0 HU; soft tissues, about –100 HU to 100 HU; bone, about 500 HU to 2000 HU.
†An important amulet that was usually placed in the mummy wrapping.
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COMPUTED TOMOGRAPHIC INVESTIGATION OF MUMMIES
Although guidelines for the examination of nonclinical
skeletal material by CT have been validated,36 the accuracy and reliability of CT in the investigation of mummified tissues has yet to be established. Current CT
protocols for mummy investigations are listed in
Table 2.17,44,48,63–65 For Rubinstein et al,66 the ideal protocol for CT of mummies should provide the “thinnest
slice, the highest spatial resolution rather than contrast
resolution, and a low radiation dose,” which is similar
to the protocol suggested earlier by Ruff and Leo.36 In
addition, initial scout view images in main planes are
important to determine whole-body CT planning, and
it is also critical to choose adequate parameters to protect the thermal capability of the x-ray tube.48
The quality of computed tomographic imaging67 in
the radiologic–anatomical assessment of mummies
has drastically improved since its earliest application
about 25 years ago.55,68–70 It is now possible to use CT to
investigate small anatomical structures such as the
middle and inner ear of a mummy.17,71 High-resolution
CT has much improved since its early use in the study
of hominoid fossils.72 Large, single trabeculae can be
visualized, and quantitative measurements of anatomical landmarks, linear and angular dimensions, as well
as cross-section area and volume calculations can be
assessed. Micro-CT73 enables the study of the microanatomy of bone architecture with a spatial resolution of a few micrometres. However, only small sample diameters of a few centimetres can be scanned.
Current state-of-the-art CT post-processing tools
include both multiplanar reformatting (MPR) and 3dimensional (3D) volume-rendered, shaded-surface
display17,37,44,48,63 of multislice CT (MSCT)74 images in
mummy research44,48 that allow faster acquisition and
improved data after processing. The advantages of radiography, single-slice CT and MSCT for the investigation of ancient human skeletal remains have been reported in the literature.75,76 Shorter data acquisition
time would theoretically be critical for studies of
frozen mummies, because they need to be sent back to
the freezer within a few minutes.19,20 MSCT also allows
a single acquisition of volume data for a whole body
and a reconstruction of a whole mummy without
much difficulty.48 On the other hand, most MSCT protocols produce a huge stack of CT images, between
1000 and 1200 for a mummified whole-body scan.48,63
Fortunately, protection of the specimen from radiation is not an issue77 for radiology as practised on ancient human skeletal remains, except its possible impact on subsequent ancient DNA examination.78
3D CT has been applied to mummies79–83 mainly to
conduct a virtual unwrapping,5,7,17,37,40,44,48,63,84,85 to identify
internal anatomy,17,48,63,82,86 to detect pathologies,17,87,88 and
to calculate endocranial capacity89 or craniometric indices.48 These reconstruction techniques allow a geometric assessment of wrappings, confirm the presence
of wads of stuffing, display the mummy’s hairstyle,
help evaluate a cranial bone fragment as associated with
a cause of death, depict subtle postmortem soft-tissue
lesion of an ear or the base of the skull, and help assess
the status of brain and intestine removal.16,63 3D CT has
also provided a precise image of a cleft lip in a child’s
mummy17 and has been used to measure the precise
stature of mummies.48 When, in occasional cases, a
wooden stick was inserted into the spinal canal during
the process of embalming, CT then has helped to deter-
Table 2: Exemplary protocols for computed tomographic studies of mummies
Structure (no. of examples)
Imaging protocol
Whole body (n = 13)
2.5-mm slice thickness, 1.25-mm reconstruction
interval, 120 kV, 140 mA
Cesarani et al48
Skull (n = 13)
1.25-mm slice thickness, 0.7-mm reconstruction
interval, 120 kV, 140 mA
Cesarani et al48
Whole body (n = 9)
3-mm slice thickness, 120–140 kV, 70–100 mA
Hoffman et al63
Skull/upper cervical spine
(n = 9)
1-mm slice thickness, 120–140 kV, 70–100 mA
Hoffman et al,63
Hoffman and
Hudgins17
Head/neck (n = 25)
1-mm slice thickness, 0.7-mm reconstruction
interval, 120 kV, 100 mA
Jansen et al44
Trunk/legs (n = 25)
3-mm slice thickness, 2-mm reconstruction
interval, 120 kV, 200 mA
Jansen et al44
Whole body (n = 1)
2.5-mm slice thickness, 2.5-mm reconstruction
interval, 120 kV, 210 mA
Shin et al64
Skull (n = 1)
2.5-mm slice thickness, 2.5-mm reconstruction
interval, 120 kV, 160 mA
Shin et al64
Scarabs (n = 9 in 25 mummies) 0.5-mm slice thickness, 0.3-mm reconstruction
interval, 120 kV, 135 mA
222
Reference
JACR VOL. 55, No 4, OCTOBRE 2004
Jansen et al65
PALEORADIOLOGY OF MUMMIFIED TISSUE
mine its location and the status of the spine itself.7,48
Dental attrition in mummies can also be assessed.90 Finally, the state of preservation of teeth48 has been evaluated using orthopantomographic or orthoradial 2D CT.91
Stereolithographic modelling of mummies,92 designed from 3D computed tomographic data, still has its
drawbacks because of high costs and being a timeconsuming procedure,92 as well as the lack of accuracy
due to the partial volume effect.35,47,93,94 Weber et al95 established an overall 2% error in the accuracy of computed tomographic measurement of the endocranial
volume of hominid skulls. Recheis et al96 determined the
error of measurement for stereolithographic models to be
0.5 mm in each dimension. Finally, Hjalgrim et al92 described a technical accuracy of 0.1 mm. Overall, the impact of stereolithographic models in evaluating mummies and skeletal human remains is better than the 2D
CT study only.94,96 The study of 3D CT in mummy facial
reconstruction97 is beyond the scope of this paper.
Virtual endoscopic “fly-through” and “autostereoscopic display” have proved useful in the investigation
of human remains.48,63,96 Invasive endoscopy can give
good insight into a mummy’s body cavities, usually by
going through artificial or postmortem created
holes. 6,34,61,98–100 In some selected cases, computerassisted101,102 and CT-guided biopsy103 are useful tools for
the assessment of internal structures within an unwrapped mummy. However, the performance of these
procedures is difficult because of the hard and dry
mummified tissue.98,103,104 Using x-rays100 or, better,
CT guidance,103 the region of the biopsy can be better
located.
The CT display window setting is important too,
because it helps identify anatomical and pathologic
structures in mummies. An all-purpose proposal for
these parameters cannot be outlined here. However,
usually a “soft-tissue” window setting produces better
contrast for mummified tissues than the bone windows. Further research is required to confirm this empirical observation.
Computed tomographic density measurement of an
unknown structure can help with its identification, because the chemical components are reflected by their
attenuation values (Hounsfield units [HU]) (Table 1).5,41
A correlation between computed tomographic features
and densities and the historical context is crucial for
the interpretation of the images.6,43 In addition, the density (HU) must be interpreted more cautiously at the
edge of a mass, and the possible presence of beamhardening artifacts should be considered.36
The assessment of the mineral content of a
mummy’s skeleton has not yet been completely explored. It has been demonstrated that the embalming
process interferes with the normal mineral content in
human bones and creates artificial results of unclear
significance.82 Assessment of the mineralization of a
mummy’s toe has been performed that has provided
evidence to support the hypothesis of its distal amputation during the individual’s life.53 Tissue demineralization and taphonomic encrustations of minerals may
actually affect CT resolution,96 as was observed for the
Iceman. Specific algorithms may help in dealing with
encrustations in fossils96 and improving morphological
analysis. These technical issues have been reviewed in
human evolutionary studies.35
Software that corrects for metal artifacts has been
used to prevent pitfalls consisting of metallic artifacts
that are caused by high-density structures such as
amulets.82 The density of nonorganic artifacts found in
Egyptian mummies has also been studied.5 CT has also
been used to identify and localize burial goods inserted
within the corpse or included in the wrappings during
the mummification process. These amulets (e.g.,
scarabs) are found in more than one-third of all mummies44 and, with the application of MPR, it is even possible to decipher the inscriptions on scarabs without the
need for an unwrapping of the mummy itself.44 In some
cases, CT has been used for an in-depth structural component analysis of famous Ancient Egyptian art.105
To conclude this section, the major advantage of
computed tomographic imaging is the generation of
digital data that can be stored, retrieved and shared
easily using electronic media and kept as a database
for a particular mummy.86
DETERMINATION OF SEX, AGE AND CAUSE OF DEATH:
ROLE OF RADIOLOGY
Age at death and sex can be difficult to determine in
mummies, especially if they are still wrapped in bandages. Well-established anthropological methods for
determining these characteristics are based on the assessment of dry bone and not on a mummy’s radiographic findings.30
Often the external and internal genitalia are no
longer present in artificial mummies because of embalming practices and the mummies are, in addition,
still wrapped. Cesarani et al106 were able to determine
sex in 11 of 13 examined mummies, but others have
had less accurate results.17,51 In one study, the penis of
the mummy could be seen on radiographs, in contrast
to the female painting of its sarcophagus.107 Braunstein
et al59 were able to determine the sex of half of a series
of 12 royal mummies using conventional radiography.
In bog bodies, sex determination was not achieved in
35% of the sample.108 If the pelvic girdle is intact, radiography performed in “standardized” planes may be
useful in the determination of sex. Furthermore, CTgenerated cephalometric data can be used to determine the sex of a mummy.109 Virtual CT reconstruction
of intact pelvic bone may help too.
To determine an individual’s age at death is difficult
CARJ VOL. 55, NO. 4, OCTOBER 2004
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RÜHLI ET AL
as well. About 30% of a sample of bog bodies could
not be linked to a particular age group.108 Various techniques have been used to overcome this major limitation and include the radiologic study of pubic bone,
but done in macerated specimens only,110 anthropometric long-bone measurements20 or dentition assessment.5,20 However, even for the otherwise extremely
well investigated Iceman, only a roughly estimated age
of 40–50 years was achieved.47 There is so far no nondestructive test available that is accurate enough to become a reference standard for the determination of the
age at death of mummies.
Cause of death is also often difficult to diagnose because of, for example, problems in differentiating periand postmortem trauma. Many published radiologic
studies fail to mention any cause of death.6,30,83,111,112
Only in exceptional cases can the cause of death be
assumed, such as a rare mummified Roman who
showed what would appear to be a bilateral fibrinous
pleurisy that may have led to death.56
OTHER IMAGING MODALITIES FOR MUMMY STUDIES
The absence of intracorporeal fluids results in a lack of
image on MRI study.7,30,37,61,113–116 Notman et al61 used a
body coil with multiple different scanning sequences
but failed except for a free-induction-decay signal,
which was too weak to generate an image. However,
Piepenbrink et al113 were able to produce MR images
with spatial resolution of 0.5 mm from rehydrated
mummified tissue. Nevertheless, they stress the difference in such images from those obtained in clinical
situations, especially the absence of lipid signals. The
role of MRI in detecting lipid signal in a mummy’s
residual fat-containing tissue has yet to be validated.
The low cost of ultrasonography and its availability
and portability made this modality a very appealing
imaging method for mummy studies in the field. Unfortunately, the presence of air and embalming substances
are major obstacles to the progression of an ultrasound
beam that prevents the formation of acceptable images.39
Conventional x-ray arthroscopy of a knee joint has
been performed in paleoimaging31 but remains anecdotal.
CONCLUSION
A thorough knowledge of the mummification process
and radiologic pitfalls, such as artifacts, is essential for
an adequate interpretation of x-ray films and computed
tomographic images of mummies. Despite the high sensitivity in anatomy and lesion detection offered by CT,
this imaging technique lacks the specificity that would
make it the modality of choice for diagnostic purposes.
Therefore, mummy autopsy remains the only reliable
reference standard for the validation of radiologic find224
JACR VOL. 55, No 4, OCTOBRE 2004
ings.117 Yet, this practice remains extremely limited because it is a destructive method for the investigation of
rare specimens, such as mummies. By default, medical
imaging modalities are the only nondestructive test
available for mummy investigation, for example, in the
assessment of skeletal pathologies that remain hidden
to direct visual examination because of the presence of
wrapping and dry flesh.
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