Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study
Silke Grabherr,Axel Heinemann,Hermann Vogel,Guy N. Rutty,Bruno Morgan,Krzysztof Woźniak,Fabrice Dedouit,Florian Fischer,Stefanie Lochner,H. Wittig,Giuseppe Guglielmi,Franziska Eplinius,Katarzyna Michaud,Cristian Palmiere,Christine Chevallier,Patrice Mangin,Jochen M. Grimm +16 more
TLDR
Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method, which may increase the quality of postmortem diagnosis.Abstract:
Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant). Results Among 18 654 findings, autopsies helped to identify 61.3% (11 433 of 18 654), postmortem CT helped to identify 76.0% (14 179 of 18 654), and postmortem CT angiography helped to identify 89.9% (16 780 of 18 654; P < .001). Postmortem CT angiography was superior to autopsy, especially at helping to identify essential skeletal lesions (96.1% [625 of 650] vs 65.4% [425 of 650], respectively; P < .001) and vascular lesions (93.5% [938 of 1003] vs 65.3% [655 of 1003], respectively; P < .001). Among the forensically essential findings, 23.4% (1029 of 4393) were not detected at autopsy, while only 9.7% (428 of 4393) were missed at postmortem CT angiography (P < .001). The best results were obtained when postmortem CT angiography was combined with autopsy. Conclusion Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method. More lesions were identified by combining postmortem CT angiography and autopsy, which may increase the quality of postmortem diagnosis. Online supplemental material is available for this article.read more
Citations
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Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification
Katarzyna Michaud,Cristina Basso,Giulia d'Amati,Carla Giordano,Ivana Kholová,Stephen D. Preston,Stefania Rizzo,Sara Sabatasso,Mary N. Sheppard,Aryan Vink,Allard C. van der Wal +10 more
TL;DR: Present knowledge and post-mortem diagnostic methods are reviewed to reveal the different types of myocardial injury and the clinical-pathological correlations with currently defined types ofMyocardial infarction.
Journal ArticleDOI
Postmortem imaging findings and cause of death determination compared with autopsy: a systematic review of diagnostic test accuracy and meta-analysis
TL;DR: Distinct postmortem imaging modalities can achieve high sensitivities for detecting various findings and causes of death and this knowledge should lead to a reasoned use of each modality.
Journal ArticleDOI
Relevant findings on postmortem CT and postmortem MRI in hanging, ligature strangulation and manual strangulation and their additional value compared to autopsy – a systematic review
TL;DR: A systematic review of the role of postmortem CT and MRI in cases of hanging and ligature and manual strangulation and compared the detectability of these findings among CT, MRI and autopsy concluded that postmortem MRI is almost equally accurate for the detection of hemorrhages in the neck.
Journal ArticleDOI
Postmortem Imaging: An Update
Francesco Pio Cafarelli,Gianpaolo Grilli,Giulio Zizzo,Giuseppe Bertozzi,Nicola Giuliani,Pasuk Mahakkanukrauh,Antonio Pinto,Giuseppe Guglielmi,Giuseppe Guglielmi +8 more
TL;DR: In this review, the newer imaging techniques in forensic radiology are explored, such as postmortem computed tomography, multiphase postmortem compute tomography angiography, and postmortem magnetic resonance imaging.
Journal ArticleDOI
Postmortem computed tomography angiography (PMCTA) and traditional autopsy in cases of sudden cardiac death due to coronary artery disease: a systematic review and meta-analysis.
Raffaele La Russa,Carlo Catalano,Mariantonia Di Sanzo,Matteo Scopetti,Vittorio Gatto,Alessandro Santurro,Rocco Valerio Viola,Valeria Panebianco,Paola Frati,Vittorio Fineschi +9 more
TL;DR: PMCTA demonstrated a high accuracy in the diagnosis of parietal and luminal coronary changes but was less effective in detecting myocardial ischemia and necrosis, suggesting that PMCTA can improve the performance of the autopsy.
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