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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 attenuation change.Scatter plot of HU ratio of PMCT/AMCT in GM and time after death (A: basal ganglia level; B: centrum semiovale level; C high convexity level). Scatter plot of HU ratio of PMCT/AMCT in WM and time after death (D: basal ganglia level; E: centrum semiovale level; C: high convexity level). *Spearman’s rank correlation.
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pone.0143848.g003: Correlation between time after death and attenuation change.Scatter plot of HU ratio of PMCT/AMCT in GM and time after death (A: basal ganglia level; B: centrum semiovale level; C high convexity level). Scatter plot of HU ratio of PMCT/AMCT in WM and time after death (D: basal ganglia level; E: centrum semiovale level; C: high convexity level). *Spearman’s rank correlation.

Mentions: Attenuation of GM and WM at each level are shown in Table 6. GM attenuation significantly increased in PMCT at the level of the centrum semiovale and high convexity. However, considering the result from our imaging phantom study, these differences were relatively smaller than the differences of CT attenuations among the different scanners. WM attenuation was significantly increased after death at all levels. These differences were large enough even when taking into account the differences of CT attenuations among the different scanners. The GM/WM ratio of attenuation was significantly lower in PMCT compared with AMCT at all levels (Table 7). The change in attenuation did not correlate with the time after death with regard to GM and WM at all levels (Fig 3).


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 attenuation change.Scatter plot of HU ratio of PMCT/AMCT in GM and time after death (A: basal ganglia level; B: centrum semiovale level; C high convexity level). Scatter plot of HU ratio of PMCT/AMCT in WM and time after death (D: basal ganglia level; E: centrum semiovale level; C: high convexity level). *Spearman’s rank correlation.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0143848.g003: Correlation between time after death and attenuation change.Scatter plot of HU ratio of PMCT/AMCT in GM and time after death (A: basal ganglia level; B: centrum semiovale level; C high convexity level). Scatter plot of HU ratio of PMCT/AMCT in WM and time after death (D: basal ganglia level; E: centrum semiovale level; C: high convexity level). *Spearman’s rank correlation.
Mentions: Attenuation of GM and WM at each level are shown in Table 6. GM attenuation significantly increased in PMCT at the level of the centrum semiovale and high convexity. However, considering the result from our imaging phantom study, these differences were relatively smaller than the differences of CT attenuations among the different scanners. WM attenuation was significantly increased after death at all levels. These differences were large enough even when taking into account the differences of CT attenuations among the different scanners. The GM/WM ratio of attenuation was significantly lower in PMCT compared with AMCT at all levels (Table 7). The change in attenuation did not correlate with the time after death with regard to GM and WM at all levels (Fig 3).

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