L Legrand1, T Delabarde2, R Souillard-Scemama3, I Sec4, I Plu5, J-M Laborie4, Y Delannoy6, L Hamza7, M Taccoen8, L de Jong9, J Benzakoun9, M Edjlali9, J-F Méder9, C Oppenheim9, B Ludes2. 1. Service d'imagerie morphologique et fonctionnelle, centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France; Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris, 102-108 rue de la Santé, 75014 Paris, France. Electronic address: l.legrand@ghu-paris.fr. 2. Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France; CNRS UMR 5288 Institut National de la transfusion sanguine, 6, rue Cabanel, 75015 Paris, France. 3. Service d'imagerie morphologique et fonctionnelle, centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France; Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France. 4. Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France; Unité médico-judiciaire, Hôtel-Dieu, 1, place du Parvis de Notre-Dame, 75004 Paris, France. 5. Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France; Sorbonne Université, 91, boulevard de l'Hôpital, 75013 Paris, France. 6. Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France; Institut médico-légal de Lille, rue André Verhaeghe, 59000 Lille, France. 7. Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France; Service d'accueil des urgences, hôpital Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France. 8. Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; Institut médico-légal de Paris, 2, place Mazas, 75012 Paris, France. 9. Service d'imagerie morphologique et fonctionnelle, centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France; Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris, 102-108 rue de la Santé, 75014 Paris, France.
Abstract
INTRODUCTION: The aim of this study was to assess the agreement between postmortem computed tomography (PMCT) and autopsy in detecting traumatic head injuries. MATERIALS AND METHODS: Consecutive cases of death that underwent both unenhanced PMCT and conventional autopsy were collected from our institution database during a period of 3 years and reviewed retrospectively. PMCT images were reviewed for the presence of fractures (cranial vault, skull base, facial bones and atlas/axis) and intracranial hemorrhage. Kappa values were calculated to determine the agreement between PMCT and autopsy reports. RESULTS: 73 cases were included, of which 44 (60%) had head trauma. Agreement between PMCT and autopsy was almost perfect (κ = 0.95) for fractures and substantial (κ = 0.75) for intracranial hemorrhage. PMCT was superior to autopsy in detecting facial bone and upper cervical spine fractures, and intraventricular hemorrhage. However, in some cases thin extra-axial blood collections were missed on PMCT. CONCLUSIONS: The agreement between PMCT and autopsy in detecting traumatic head injuries was good. Using a combination of both techniques increases the quality of postmortem evaluation because more lesions are detected.
INTRODUCTION: The aim of this study was to assess the agreement between postmortem computed tomography (PMCT) and autopsy in detecting traumatic head injuries. MATERIALS AND METHODS: Consecutive cases of death that underwent both unenhanced PMCT and conventional autopsy were collected from our institution database during a period of 3 years and reviewed retrospectively. PMCT images were reviewed for the presence of fractures (cranial vault, skull base, facial bones and atlas/axis) and intracranial hemorrhage. Kappa values were calculated to determine the agreement between PMCT and autopsy reports. RESULTS: 73 cases were included, of which 44 (60%) had head trauma. Agreement between PMCT and autopsy was almost perfect (κ = 0.95) for fractures and substantial (κ = 0.75) for intracranial hemorrhage. PMCT was superior to autopsy in detecting facial bone and upper cervical spine fractures, and intraventricular hemorrhage. However, in some cases thin extra-axial blood collections were missed on PMCT. CONCLUSIONS: The agreement between PMCT and autopsy in detecting traumatic head injuries was good. Using a combination of both techniques increases the quality of postmortem evaluation because more lesions are detected.
Authors: Mikkel Jon Henningsen; Mette Lønstrup Harving; Christina Jacobsen; Chiara Villa Journal: Int J Legal Med Date: 2022-01-27 Impact factor: 2.791