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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

Dissection and hypostasis in ascending aorta in 76-year-old deceased woman (case 6).CT scan obtained 14 hours and 30 minutes after death shows both flap (arrow) separating two lumens and hypostasis (arrowhead) in ascending aorta. Increased density and thickening of aortic wall, which are normal postmortem changes, are also observed (dotted arrow). CT = computed tomography
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Figure 4: Dissection and hypostasis in ascending aorta in 76-year-old deceased woman (case 6).CT scan obtained 14 hours and 30 minutes after death shows both flap (arrow) separating two lumens and hypostasis (arrowhead) in ascending aorta. Increased density and thickening of aortic wall, which are normal postmortem changes, are also observed (dotted arrow). CT = computed tomography

Mentions: Aortic dissection also mimics hypostasis on postmortem CT. In case 6, a flap separating two lumens and hypostasis were observed within the ascending aorta on postmortem CT (Fig. 4, arrow and arrowheads, respectively). Both lesions exhibited high density. Increased density and aortic wall thickening, which are normal postmortem changes, were also observed (Fig. 4, dotted arrow). Several studies have evaluated the postmortem changes in the aorta. Okuma et al. (18) observed an increased aortic wall thickness on postmortem CT compared with AMCT in the same patients, and Shiotani et al. (37) reported an increased aortic wall density on postmortem CT. This increased density may be confused with aortic dissection by radiologists who are inexperienced with postmortem imaging. Takahashi et al. (38) and Hyodoh et al. (39) similarly described the postmortem changes in the aortic form. They reported that the aortic diameter and overall size decreased postmortem. The descending thoracic and abdominal aorta in particular became ovoid (38). These deformations are considered normal postmortem changes.


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)

Dissection and hypostasis in ascending aorta in 76-year-old deceased woman (case 6).CT scan obtained 14 hours and 30 minutes after death shows both flap (arrow) separating two lumens and hypostasis (arrowhead) in ascending aorta. Increased density and thickening of aortic wall, which are normal postmortem changes, are also observed (dotted arrow). CT = computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Dissection and hypostasis in ascending aorta in 76-year-old deceased woman (case 6).CT scan obtained 14 hours and 30 minutes after death shows both flap (arrow) separating two lumens and hypostasis (arrowhead) in ascending aorta. Increased density and thickening of aortic wall, which are normal postmortem changes, are also observed (dotted arrow). CT = computed tomography
Mentions: Aortic dissection also mimics hypostasis on postmortem CT. In case 6, a flap separating two lumens and hypostasis were observed within the ascending aorta on postmortem CT (Fig. 4, arrow and arrowheads, respectively). Both lesions exhibited high density. Increased density and aortic wall thickening, which are normal postmortem changes, were also observed (Fig. 4, dotted arrow). Several studies have evaluated the postmortem changes in the aorta. Okuma et al. (18) observed an increased aortic wall thickness on postmortem CT compared with AMCT in the same patients, and Shiotani et al. (37) reported an increased aortic wall density on postmortem CT. This increased density may be confused with aortic dissection by radiologists who are inexperienced with postmortem imaging. Takahashi et al. (38) and Hyodoh et al. (39) similarly described the postmortem changes in the aortic form. They reported that the aortic diameter and overall size decreased postmortem. The descending thoracic and abdominal aorta in particular became ovoid (38). These deformations are considered normal postmortem changes.

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