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Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study

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journal contribution
posted on 2019-12-11, 14:38 authored by Silke Grabherr, Axel Heinemann, Hermann Vogel, Guy Rutty, Bruno Morgan, Krzysztof Woźniak, Fabrice Dedouit, Florian Fischer, Stefanie Lochner, Holger Wittig, Giuseppe Guglielmi, Franziska Eplinius, Katarzyna Michaud, Cristian Palmiere, Christine Chevallier, Patrice Mangin, Jochen M. Grimm
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.

Funding

Fumedica AG, Muri, Switzerland.

History

Citation

Radiology 2018; 288:270–276

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/Biological Sciences/Genetics and Genome Biology

Version

  • VoR (Version of Record)

Published in

Radiology

Volume

288

Issue

1

Pagination

270-276

Publisher

Radiological Society of North America

issn

0033-8419

eissn

1527-1315

Acceptance date

2018-01-24

Copyright date

2018

Available date

2019-12-11

Publisher version

https://pubs.rsna.org/doi/10.1148/radiol.2018170559

Language

en

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