Mathilde Ducloyer1,2, Lucile Tuchtan3,4, Clémence Delteil3,4, Marie-Dominique Piercecchi3,4, Arthur David5, Guillaume Visseaux6, Renaud Bouvet7, Guillaume Gorincour8, Renaud Clement6. 1. Forensic Medicine Department, Centre Hospitalier Universitaire de Nantes, 30 Boulevard Jean Monnet, 44000, Nantes, France. Mathilde.ducloyer@chu-nantes.fr. 2. Department of Radiology, Centre Hospitalier Universitaire de Nantes, Nantes, France. Mathilde.ducloyer@chu-nantes.fr. 3. Forensic Medicine Department, APHM, Hopital de la Timone, Marseille, France. 4. CNRS, EFS, ADES, Aix Marseille Université, Marseille, France. 5. Department of Radiology, Centre Hospitalier Universitaire de Nantes, Nantes, France. 6. Forensic Medicine Department, Centre Hospitalier Universitaire de Nantes, 30 Boulevard Jean Monnet, 44000, Nantes, France. 7. Forensic Medicine Department, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, IDPSP EA 4640, Rennes, France. 8. Laboratoire d'Imagerie Interventionnelle et Expérimentale, LiiE, EA4264, Aix Marseille Université, Marseille, France.
Abstract
INTRO: Evidence of breath after birth is one of the main forensic issues in suspected neonaticide. Hydrostatic test (HT) and pathological examination are currently used to assess it, but they are not entirely reliable or immediately available. OBJECTIVE: To determine the performance of postmortem computed tomography (PMCT) to assess neonatal breath in suspected neonaticide, by comparing lung CT attenuation values between live birth and stillbirth cases, in correlation with HT and pathology. METHOD: Cases of suspected neonaticides who underwent a PMCT and complete forensic autopsy with an HT were retrospectively selected from the databases of four French Forensic Medicine Departments. The diagnosis of vitality (i.e., stillbirth or live birth) was based on the pathological examination and/or a combination of arguments, including HT result. Lung density on CT was measured in Hounsfield units (HU) by ROIs drawn in both pulmonary parenchymas. RESULTS: Eleven patients were included, six live birth and five stillbirth cases. The result of HT was concordant with pathological examination when available (seven cases). Mean lung densities in live birth cases (- 173 HU [- 255; - 91 CI 95%]) were significantly lower than in stillbirth cases (40 HU [28; 52 CI 95%]) (p < 0.05), with a very high degree of interobserver reproducibility (ICC = 0.998 (CI 95% 0.991-0.999; p < 0.001). CONCLUSION: PMCT and especially lung CT attenuation measurement is a reliable and easy-to-use method for assessing neonatal breath in suspected neonaticides.
INTRO: Evidence of breath after birth is one of the main forensic issues in suspected neonaticide. Hydrostatic test (HT) and pathological examination are currently used to assess it, but they are not entirely reliable or immediately available. OBJECTIVE: To determine the performance of postmortem computed tomography (PMCT) to assess neonatal breath in suspected neonaticide, by comparing lung CT attenuation values between live birth and stillbirth cases, in correlation with HT and pathology. METHOD: Cases of suspected neonaticides who underwent a PMCT and complete forensic autopsy with an HT were retrospectively selected from the databases of four French Forensic Medicine Departments. The diagnosis of vitality (i.e., stillbirth or live birth) was based on the pathological examination and/or a combination of arguments, including HT result. Lung density on CT was measured in Hounsfield units (HU) by ROIs drawn in both pulmonary parenchymas. RESULTS: Eleven patients were included, six live birth and five stillbirth cases. The result of HT was concordant with pathological examination when available (seven cases). Mean lung densities in live birth cases (- 173 HU [- 255; - 91 CI 95%]) were significantly lower than in stillbirth cases (40 HU [28; 52 CI 95%]) (p < 0.05), with a very high degree of interobserver reproducibility (ICC = 0.998 (CI 95% 0.991-0.999; p < 0.001). CONCLUSION: PMCT and especially lung CT attenuation measurement is a reliable and easy-to-use method for assessing neonatal breath in suspected neonaticides.
Entities:
Keywords:
Live birth; Lung density; Neonaticide; Postmortem computed tomography; Stillbirth
Authors: Anna-Lena Große Ostendorf; Markus A Rothschild; Annette M Müller; Sibylle Banaschak Journal: Int J Legal Med Date: 2012-06-26 Impact factor: 2.686