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Post-mortem computed tomography ventilation; simulating breath holding

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Abstract

Whilst the literature continues to report on advances in the use of post-mortem computed tomography (PMCT), particularly in relation to post-mortem angiography, there are few papers published that address the diagnostic problems related to post-mortem changes in the lungs and ventilation. We present a development of previous methods to achieve ventilated PMCT (VPMCT). We successfully introduced a supraglottic airway in 17/18 cases without causing overt damage, despite rigor mortis. Using a clinical portable ventilator, we delivered continuous positive airway pressure to mimic clinical breath-hold inspiratory scans. This caused significant lung expansion and a reduction in lung density and visible normal post-mortem changes. All thoracic pathology identified at autopsy, including pneumonia, was diagnosed on VPMCT in this small series. This technique provides a rapid form of VPMCT, which can be used in both permanent and temporary mortuaries, allowing for the post-mortem radiological comparison of pre-ventilation and post-ventilation images mimicking expiratory and inspiratory phases. We believe that it will enhance the diagnostic ability of PMCT in relation to lung pathology.

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Acknowledgments

We wish to thank the relatives who gave consent for their recently departed loved ones to be part of this study. We also wish to thank H.M. Coroners’ offices for North and South Leicestershire for their support of this project, as well as our study coordinator, T Visser, and all the porters, morticians and radiographers who supported this project. This article presents independent research funded by the Home Office Science Secretariat, Science Group. The views expressed in this publication are those of the author(s) and not necessarily those of the Home Office.

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Authors and Affiliations

  1. Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, LE2 7LX, UK

    C. Robinson, M. Pakkal & B. Morgan

  2. East Midlands Forensic Pathology Unit, University of Leicester, Robert Kilpatrick Building, Leicester, LE2 7LX, UK

    M. J. Biggs, J. Amoroso & G. N Rutty

Authors
  1. C. Robinson
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  2. M. J. Biggs
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  3. J. Amoroso
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  4. M. Pakkal
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  5. B. Morgan
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  6. G. N Rutty
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Corresponding author

Correspondence to G. N Rutty.

Additional information

B Morgan and G Rutty contributed equally to this work.

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Robinson, C., Biggs, M.J., Amoroso, J. et al. Post-mortem computed tomography ventilation; simulating breath holding. Int J Legal Med 128, 139–146 (2014). https://doi.org/10.1007/s00414-013-0943-3

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  • DOI: https://doi.org/10.1007/s00414-013-0943-3

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