PURPOSE: We attempted to obtain postmortem computed tomographic (PMCT) images of the lung in cases of non-traumatic death and describe the results to distinguish usual postmortem findings from those of specific thoracic causes of death. MATERIALS AND METHODS: Our subjects were a total of 150 consecutive non-traumatic cases with cardiopulmonary arrest on arrival who were examined by CT within 2h after certification of death between January 1993 and December 2001. PMCT images of the lung and the frequency of imaging findings (dependent density, ground glass attenuation (GGA), consolidation, pleural effusion, and endotracheal (or endobronchial) air defect) were retrospectively reviewed. Autopsy had been conducted in 16 of the cases. RESULTS: The causes of death and frequency percentages of dependent density, GGA, consolidation, pleural effusion, and endotracheal (or endobronchial) air defect were: 91 cases of acute heart failure (AHF) (69, 66, 24, 11, 14%), 23 cases of aortic dissection (57, 39, 4, 52, 0%), 11 cases of pneumonia (18, 82, 100, 45, 27%), 23 other specified cases (52, 30, 13, 17, 9%), and two unspecified cases (0, 0, 0, 50, 0%), [total respective frequency percentages were (60, 57, 25, 21, 12%)]. Autopsy confirmed that GGA on PMCT in AHF cases corresponded to pulmonary edema. CONCLUSION: When PMCT of the lung shows no other shadows than dependent density, further analysis is necessary to detect the cause of death.
PURPOSE: We attempted to obtain postmortem computed tomographic (PMCT) images of the lung in cases of non-traumatic death and describe the results to distinguish usual postmortem findings from those of specific thoracic causes of death. MATERIALS AND METHODS: Our subjects were a total of 150 consecutive non-traumatic cases with cardiopulmonary arrest on arrival who were examined by CT within 2h after certification of death between January 1993 and December 2001. PMCT images of the lung and the frequency of imaging findings (dependent density, ground glass attenuation (GGA), consolidation, pleural effusion, and endotracheal (or endobronchial) air defect) were retrospectively reviewed. Autopsy had been conducted in 16 of the cases. RESULTS: The causes of death and frequency percentages of dependent density, GGA, consolidation, pleural effusion, and endotracheal (or endobronchial) air defect were: 91 cases of acute heart failure (AHF) (69, 66, 24, 11, 14%), 23 cases of aortic dissection (57, 39, 4, 52, 0%), 11 cases of pneumonia (18, 82, 100, 45, 27%), 23 other specified cases (52, 30, 13, 17, 9%), and two unspecified cases (0, 0, 0, 50, 0%), [total respective frequency percentages were (60, 57, 25, 21, 12%)]. Autopsy confirmed that GGA on PMCT in AHF cases corresponded to pulmonary edema. CONCLUSION: When PMCT of the lung shows no other shadows than dependent density, further analysis is necessary to detect the cause of death.
Authors: C Jackowski; M Thali; E Aghayev; K Yen; M Sonnenschein; K Zwygart; R Dirnhofer; P Vock Journal: Int J Legal Med Date: 2005-11-19 Impact factor: 2.686