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Brain Swelling and Loss of Gray and White Matter Differentiation in Human Postmortem Cases by Computed Tomography.

Shirota G, Gonoi W, Ishida M, Okuma H, Shintani Y, Abe H, Takazawa Y, Ikemura M, Fukayama M, Ohtomo K - PLoS ONE (2015)

Bottom Line: WM attenuation significantly increased after death at all levels (P<0.0001).GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001).PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

ABSTRACT
The purpose of this study was to evaluate the brain by postmortem computed tomography (PMCT) versus antemortem computed tomography (AMCT) using brains from the same patients. We studied 36 nontraumatic subjects who underwent AMCT, PMCT, and pathological autopsy in our hospital between April 2009 and December 2013. PMCT was performed within 20 h after death, followed by pathological autopsy including the brain. Autopsy confirmed the absence of intracranial disorders that might be related to the cause of death or might affect measurements in our study. Width of the third ventricle, width of the central sulcus, and attenuation in gray matter (GM) and white matter (WM) from the same area of the basal ganglia, centrum semiovale, and high convexity were statistically compared between AMCT and PMCT. Both the width of the third ventricle and the central sulcus were significantly shorter in PMCT than in AMCT (P < 0.0001). GM attenuation increased after death at the level of the centrum semiovale and high convexity, but the differences were not statistically significant considering the differences in attenuation among the different computed tomography scanners. WM attenuation significantly increased after death at all levels (P<0.0001). The differences were larger than the differences in scanners. GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001). PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

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Correlation between time after death and changes in the width of the third ventricle and the central sulcus.(A) Scatter plot of the ratio of PMCT/AMCT in the width of the third ventricle and time after death. (B) Scatter plot of the ratio of PMCT/AMCT in the width of the central sulcus and time after death. *Spearman’s rank correlation.
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pone.0143848.g002: Correlation between time after death and changes in the width of the third ventricle and the central sulcus.(A) Scatter plot of the ratio of PMCT/AMCT in the width of the third ventricle and time after death. (B) Scatter plot of the ratio of PMCT/AMCT in the width of the central sulcus and time after death. *Spearman’s rank correlation.

Mentions: The widths of the ventricles and the central sulci were compared between AMCT and PMCT. Both the widths of the third ventricles and the central sulci were significantly shorter in PMCT compared with AMCT (Table 3). These changes in the indicators reflect brain swelling in PMCT. Changes in the indicators above did no correlate with the time after death (Fig 2).


Brain Swelling and Loss of Gray and White Matter Differentiation in Human Postmortem Cases by Computed Tomography.

Shirota G, Gonoi W, Ishida M, Okuma H, Shintani Y, Abe H, Takazawa Y, Ikemura M, Fukayama M, Ohtomo K - PLoS ONE (2015)

Correlation between time after death and changes in the width of the third ventricle and the central sulcus.(A) Scatter plot of the ratio of PMCT/AMCT in the width of the third ventricle and time after death. (B) Scatter plot of the ratio of PMCT/AMCT in the width of the central sulcus and time after death. *Spearman’s rank correlation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664263&req=5

pone.0143848.g002: Correlation between time after death and changes in the width of the third ventricle and the central sulcus.(A) Scatter plot of the ratio of PMCT/AMCT in the width of the third ventricle and time after death. (B) Scatter plot of the ratio of PMCT/AMCT in the width of the central sulcus and time after death. *Spearman’s rank correlation.
Mentions: The widths of the ventricles and the central sulci were compared between AMCT and PMCT. Both the widths of the third ventricles and the central sulci were significantly shorter in PMCT compared with AMCT (Table 3). These changes in the indicators reflect brain swelling in PMCT. Changes in the indicators above did no correlate with the time after death (Fig 2).

Bottom Line: WM attenuation significantly increased after death at all levels (P<0.0001).GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001).PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

ABSTRACT
The purpose of this study was to evaluate the brain by postmortem computed tomography (PMCT) versus antemortem computed tomography (AMCT) using brains from the same patients. We studied 36 nontraumatic subjects who underwent AMCT, PMCT, and pathological autopsy in our hospital between April 2009 and December 2013. PMCT was performed within 20 h after death, followed by pathological autopsy including the brain. Autopsy confirmed the absence of intracranial disorders that might be related to the cause of death or might affect measurements in our study. Width of the third ventricle, width of the central sulcus, and attenuation in gray matter (GM) and white matter (WM) from the same area of the basal ganglia, centrum semiovale, and high convexity were statistically compared between AMCT and PMCT. Both the width of the third ventricle and the central sulcus were significantly shorter in PMCT than in AMCT (P < 0.0001). GM attenuation increased after death at the level of the centrum semiovale and high convexity, but the differences were not statistically significant considering the differences in attenuation among the different computed tomography scanners. WM attenuation significantly increased after death at all levels (P<0.0001). The differences were larger than the differences in scanners. GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001). PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

Show MeSH
Related in: MedlinePlus