Aims and objectives
The utility of post-mortem computed tomography (PMCT),
which is generally used in forensic medicine,
has become recognized [1-3].
Radiologists also have more opportunity to see PMCT images.
However,
it remains difficult to interpret PMCT scans because many changes occur after death and it is impossible to perform contrast-enhanced CT on the deceased,
unlike in clinical practice.
Therefore,
radiologists should thoroughly compare PMCT findings to autopsy findings to gain adequate knowledge on post-mortem radiological imaging.
Using PMCT,
it is often difficult to identify a direct cause...
Methods and materials
Study cases
We retrospectively reviewed 214 cases that underwent PMCT and forensic autopsies from January 2015 to December 2015 at our institution.
We excluded cases with severe pneumothorax or haematothorax,
a large pleural effusion,
severe trauma,
infants,
pronounced decomposition,
and those who were mummified.
Ultimately,
170 cases were selected.
Their average age at death was 59 (range,
8–91) years,
and there were 50 females and 120 males.
CT and autopsy
We used 8- or 64-channel multi-detector row CT scanners (Aquilion; Toshiba Medical Systems,
Tokyo,
Japan)....
Results
The lung PMCT findings were classified into eight types: almost none ( Fig. 1 ),
oedema spread via the airways ( Fig. 2 ),
inhomogeneous oedema extending to the subpleura ( Fig. 3 ),
inhomogeneous oedema with subpleural sparing ( Fig. 4 ),
diffuse oedema ( Fig. 5 ),
major hypostasis ( Fig. 6 ),
minor hypostasis ( Fig. 7 ),
and other.
The causes of death were drowning (n=36),
hypothermia (n=16),
ischaemic heart disease (n=11),
non-ischaemic heart disease (n=27),
head injury (n=11),
intracranial haemorrhage...
Conclusion
Hypothermia and drowning cases exhibited characteristic lung features in PMCT scans.
Death from hypothermia and drowning were eminently diagnosable based solely on PMCT lung findings.
Personal information
Yusuke KAWASUMI,
M.D.,
Ph.D.
Tohoku University
Graduate School of Medicine
Clinical Imaging
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