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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

Hypostasis and thrombosis in great vessels in 45-year-old deceased man (case 5).CT scan obtained 2 hours and 8 minutes after death shows hypostasis in thoracic aorta (A, arrow). Hyperdense cast is present within left pulmonary artery (A, arrowheads), which is later diagnosed as pulmonary thrombus on autopsy (B, arrow). CT = computed tomography
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Figure 3: Hypostasis and thrombosis in great vessels in 45-year-old deceased man (case 5).CT scan obtained 2 hours and 8 minutes after death shows hypostasis in thoracic aorta (A, arrow). Hyperdense cast is present within left pulmonary artery (A, arrowheads), which is later diagnosed as pulmonary thrombus on autopsy (B, arrow). CT = computed tomography

Mentions: In case 5, hypostasis was observed in the thoracic aorta on postmortem CT (Fig. 3A, arrow). In the left pulmonary artery, an immobile hyperdense cast was detected (Fig. 3A, arrowheads) and differed from the left atrium and thoracic aorta findings, which formed a fluid-fluid level, and also from postmortem clotting, which was mostly concentrated in a free-floating manner near the horizontal border of the hypostasis within the large vessels. Thus, pulmonary thrombosis was suspected and subsequently confirmed on autopsy (Fig. 3B, arrow). Although pulmonary thrombosis varies in density and form, it is distinguishable from hypostasis. The key features suggesting pulmonary thrombus are a blood clot with a non-fluid-fluid level and hyperdense cast formation occluding the pulmonary artery (343536). However, this standard should not be applied when the posture of the cadaver is changed.


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)

Hypostasis and thrombosis in great vessels in 45-year-old deceased man (case 5).CT scan obtained 2 hours and 8 minutes after death shows hypostasis in thoracic aorta (A, arrow). Hyperdense cast is present within left pulmonary artery (A, arrowheads), which is later diagnosed as pulmonary thrombus on autopsy (B, arrow). CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Hypostasis and thrombosis in great vessels in 45-year-old deceased man (case 5).CT scan obtained 2 hours and 8 minutes after death shows hypostasis in thoracic aorta (A, arrow). Hyperdense cast is present within left pulmonary artery (A, arrowheads), which is later diagnosed as pulmonary thrombus on autopsy (B, arrow). CT = computed tomography
Mentions: In case 5, hypostasis was observed in the thoracic aorta on postmortem CT (Fig. 3A, arrow). In the left pulmonary artery, an immobile hyperdense cast was detected (Fig. 3A, arrowheads) and differed from the left atrium and thoracic aorta findings, which formed a fluid-fluid level, and also from postmortem clotting, which was mostly concentrated in a free-floating manner near the horizontal border of the hypostasis within the large vessels. Thus, pulmonary thrombosis was suspected and subsequently confirmed on autopsy (Fig. 3B, arrow). Although pulmonary thrombosis varies in density and form, it is distinguishable from hypostasis. The key features suggesting pulmonary thrombus are a blood clot with a non-fluid-fluid level and hyperdense cast formation occluding the pulmonary artery (343536). However, this standard should not be applied when the posture of the cadaver is changed.

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