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Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus

Three lesion patterns on postmortem CT images of brain.A. Pattern 1. CT scan of 53-year-old deceased woman obtained 1 hour and 35 minutes after death shows unremarkable postmortem changes (case 2). B. Pattern 2. CT scan of 39-year-old deceased woman obtained 9 hours and 9 minutes after death shows diffuse brain swelling (case 3). C. Pattern 3. CT scan of 78-year-old deceased man obtained 14 hours and 41 minutes after death shows both diffuse brain swelling and loss of distinction between gray and white matter (case 4). CT = computed tomography
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Figure 2: Three lesion patterns on postmortem CT images of brain.A. Pattern 1. CT scan of 53-year-old deceased woman obtained 1 hour and 35 minutes after death shows unremarkable postmortem changes (case 2). B. Pattern 2. CT scan of 39-year-old deceased woman obtained 9 hours and 9 minutes after death shows diffuse brain swelling (case 3). C. Pattern 3. CT scan of 78-year-old deceased man obtained 14 hours and 41 minutes after death shows both diffuse brain swelling and loss of distinction between gray and white matter (case 4). CT = computed tomography

Mentions: In cases 2, 3, and 4, three patterns were observed on brain postmortem CT. These cases indicate that the following patterns may be found in the brain following an in-hospital atraumatic death: 1) unremarkable postmortem change (Fig. 2A); 2) brain swelling represented by decreases in the ventricle and sulci sizes (Fig. 2B); and 3) diffuse brain swelling with absent GM-WM distinction (Fig. 2C). In cases 2, 3, and 4, death occurred 1 hour and 35 minutes, 9 hours and 9 minutes, and 14 hours and 41 minutes after the postmortem CT, respectively. These patterns may be interpreted differently depending on patient characteristics such as age or concurrent antemortem lesions. It remains unclear how these postmortem CT findings reflect the antemortem pathology or the interval between death and postmortem CT, and whether the postmortem elapsed time and magnitude of brain swelling are correlated (33).


Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions.

Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K - Korean J Radiol (2015)

Three lesion patterns on postmortem CT images of brain.A. Pattern 1. CT scan of 53-year-old deceased woman obtained 1 hour and 35 minutes after death shows unremarkable postmortem changes (case 2). B. Pattern 2. CT scan of 39-year-old deceased woman obtained 9 hours and 9 minutes after death shows diffuse brain swelling (case 3). C. Pattern 3. CT scan of 78-year-old deceased man obtained 14 hours and 41 minutes after death shows both diffuse brain swelling and loss of distinction between gray and white matter (case 4). CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499544&req=5

Figure 2: Three lesion patterns on postmortem CT images of brain.A. Pattern 1. CT scan of 53-year-old deceased woman obtained 1 hour and 35 minutes after death shows unremarkable postmortem changes (case 2). B. Pattern 2. CT scan of 39-year-old deceased woman obtained 9 hours and 9 minutes after death shows diffuse brain swelling (case 3). C. Pattern 3. CT scan of 78-year-old deceased man obtained 14 hours and 41 minutes after death shows both diffuse brain swelling and loss of distinction between gray and white matter (case 4). CT = computed tomography
Mentions: In cases 2, 3, and 4, three patterns were observed on brain postmortem CT. These cases indicate that the following patterns may be found in the brain following an in-hospital atraumatic death: 1) unremarkable postmortem change (Fig. 2A); 2) brain swelling represented by decreases in the ventricle and sulci sizes (Fig. 2B); and 3) diffuse brain swelling with absent GM-WM distinction (Fig. 2C). In cases 2, 3, and 4, death occurred 1 hour and 35 minutes, 9 hours and 9 minutes, and 14 hours and 41 minutes after the postmortem CT, respectively. These patterns may be interpreted differently depending on patient characteristics such as age or concurrent antemortem lesions. It remains unclear how these postmortem CT findings reflect the antemortem pathology or the interval between death and postmortem CT, and whether the postmortem elapsed time and magnitude of brain swelling are correlated (33).

Bottom Line: Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine.However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts.In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan. ; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan.

ABSTRACT
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.

No MeSH data available.


Related in: MedlinePlus