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Performance of post-mortem CT compared to autopsy in children

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Abstract

Introduction

Radiological techniques such as non-enhanced post-mortem computed tomography (PMCT) play an increasingly important role in death investigations, especially in cases of non-medicolegal context of death, where the consent of the next of kin is required to perform autopsy. Such consent is often difficult to obtain for deceased children, and radiological methods may be an acceptable alternative. The aim of our study was to evaluate the performance of PMCT explorations compared to medicolegal conventional autopsies in children and its potential usefulness in non-medicolegal situations.

Methods

We retrospectively reviewed a group of 26 children aged 0–12 years who died of different causes, which were investigated by both conventional autopsy and PMCT. We compared the findings extracted from radiological and autopsy reports. All findings were grouped according to their importance with respect to cause of death and to the anatomical structure they covered: organs, vascular system, soft tissue, and skeletal system.

Results

A significantly larger number of findings were detected by autopsy compared to PMCT. Autopsy proved to be superior to PMCT, notably at detecting organ, soft tissue, and vascular findings, while PMCT was superior at detecting bone findings. However, no statistically significant differences were found between the methods concerning the essential findings used to define the cause of death.

Conclusions

In children, PMCT was less sensitive than conventional autopsy for detecting general findings. However, most essential findings were detected by both methods. PMCT was superior to autopsy for the detection of bone lesions in children.

Advances in knowledge

Up to today, very rare literature exists concerning PMCT in children, especially in a forensic setting. This article investigates the advantages and limitations of PMCT compared to autopsy in a unique study group and discusses possibilities for future developments.

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Acknowledgments

The authors thank the radiographers, technicians, and doctors of the University Center of Legal Medicine Lausanne—Geneva and the Department of Pathology and the Faculdade de Medicina da Universidade de São Paulo, who dedicated their efforts to conducting this work.

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Authors and Affiliations

  1. University Center of Legal Medicine Lausanne-Geneva, University Hospital of Lausanne, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland

    Beatriz V. Krentz, Jochen Grimm, Fabrice Dédouit, Christine Bruguier, Christine Chevallier, Coraline Egger & Silke Grabherr

  2. Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Beatriz V. Krentz & Luiz F. F. Da Silva

  3. Department of Diagnostic and Interventional Radiology, University Hospital of Lausanne, Lausanne, Switzerland

    Leonor Alamo, Jochen Grimm, Christine Bruguier & Christine Chevallier

Authors
  1. Beatriz V. Krentz
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  2. Leonor Alamo
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  3. Jochen Grimm
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  4. Fabrice Dédouit
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  5. Christine Bruguier
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  6. Christine Chevallier
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  7. Coraline Egger
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  8. Luiz F. F. Da Silva
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  9. Silke Grabherr
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Corresponding author

Correspondence to Silke Grabherr.

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Funding information

One of the authors (SG) has a personal research grant from the Fondation Leenards (Lausanne, Switzerland).

Conflict of interest

The authors declare that they have no conflict of interest.

Financial disclosures

•The first author (Silke Grabherr) has a personal academic funding from the Fondation Leenards, Lausanne, Switzerland since April 2011.

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Krentz, B.V., Alamo, L., Grimm, J. et al. Performance of post-mortem CT compared to autopsy in children. Int J Legal Med 130, 1089–1099 (2016). https://doi.org/10.1007/s00414-016-1370-z

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  • DOI: https://doi.org/10.1007/s00414-016-1370-z

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