Forensic postmortem computed tomography: volumetric measurement of the heart and liver

Jakobsen, Louise Kollander; Lundemose, Sissel Banner; Banner, Jytte; Lynnerup, Niels; Jacobsen, Christina

doi:10.1007/s12024-016-9810-0

Cited by 14 publications

(6 citation statements)

References 15 publications

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“…A formula of adjusted CTR-based score could help to predict "cardiomegaly" at postmortem computed tomography (PMCT) [15]. Several studies showed that postmortem radiological measurements of wall thicknesses including PMCT and postmortem magnetic resonance (PMMR) differ from corresponding autopsy measurements [16][17][18][19][20]. It was shown that LV wall thickness was significantly higher on PMCT compared to PMMR and that LV anterior wall thickness was significantly higher on PMMR than at autopsy [17].…”

Section: Interstitial Fibrosismentioning

confidence: 99%

Cardiac hypertrophy at autopsy

et al. 2021

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Since cardiac hypertrophy may be considered a cause of death at autopsy, its assessment requires a uniform approach. Common terminology and methodology to measure the heart weight, size, and thickness as well as a systematic use of cut off values for normality by age, gender, and body weight and height are needed. For these reasons, recommendations have been written on behalf of the Association for European Cardiovascular Pathology. The diagnostic work up implies the search for pressure and volume overload conditions, compensatory hypertrophy, storage and infiltrative disorders, and cardiomyopathies. Although some gross morphologic features can point to a specific diagnosis, systematic histologic analysis, followed by possible immunostaining and transmission electron microscopy, is essential for a final diagnosis. If the autopsy is carried out in a general or forensic pathology service without expertise in cardiovascular pathology, the entire heart (or pictures) together with mapped histologic slides should be sent for a second opinion to a pathologist with such an expertise. Indication for postmortem genetic testing should be integrated into the multidisciplinary management of sudden cardiac death.

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Section: Interstitial Fibrosismentioning

confidence: 99%

Cardiac hypertrophy at autopsy

et al. 2021

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“…One person conducted the manual segmentation and this is a limitation. However, CTR measurements and volumetric organ measurements have shown high interrater agreements [2,3,6,30,31]. Secondly, not all possible causes of death were assessed and hypothermia group was very small so the two hypothermia cases which fulfilled the inclusion criteria had to be excluded from the analysis.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the mediastinal-thoracic volume ratio on postmortem computed tomography

et al. 2021

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Objectives The aim of this study was to measure the mediastinal-thoracic volume ratio (CTR_VOL) on PMCT as a more accurate version of traditional CTR, in order to assess the terminal positional relationship between the heart and lungs in the different causes of death with regard to age, gender, BMI, cardiomegaly, and lung expansion. Materials Two hundred fifty consecutive postmortem cases with pre-autopsy PMCT and full forensic autopsy were retrospectively evaluated. The lungs and the mediastinum were manually segmented on the PMCT data and the correspondent volumes were estimated in situ. CTR_VOL was calculated as the ratio of the mediastinal to the thoracic volume. The volume measurements were repeated by the same rater for the evaluation of the intrarater reliability. Age, gender, body weight and height, heart weight at autopsy, and cause of death were retrieved from the autopsy reports. Presence of lung expansion was radiologically evaluated in situ. Results CTR_VOL was positively associated with age and BMI but not with gender and was higher for cardiomegaly compared to normal hearts, lower for asphyxiation-related deaths compared to cardiac deaths and intoxications, and lower for cases with lung expansion. The intrarater reliability was excellent for the calculated volumes of both lungs and mediastinum. Conclusion The results of the present study support CTR_VOL as a tool to assess the relationship between the heart and lungs in situ, which differs significantly between the studied cause of death categories.

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“…However, they suffer from several disadvantages at the moment, which is why they cannot substitute traditional autopsy in all cases. Specifically, virtual autopsy cannot provide information about the odour and texture of organs, as well as volume measurements, which may be of great importance in diagnostics (Bolliger & Thali, 2015;Jakobsen et al 2016).…”

Section: Discussionmentioning

confidence: 99%

Virtual autopsy in legal medicine: literature review and example of application on the mummified remains

Kružić

Jerković

Mihanović

et al. 2018

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The virtual autopsy and post-mortem imaging methods are relatively novel methods used in medicine to determine cause and manner of death. They can also be exceptionally useful in the process of identification. Although they have numerous advantages, they are still not implemented in practice to a sufficient extent because the methodology has not yet been validated, and studies that deal with legal and practical implications of those methods are relatively scarce. In this article we describe basic principles and advantages of the methodology, explore related legal and practical issues, and present a case of virtual autopsy in practice on the mummified remains of St. Ivan Olini from Church of St. Blaise in Vodnjan (Croatia).Virtualna obdukcija in postmortalna metoda slikanja sta relativno novi metodi v medicini za ugotovljanje vzroka in načina smrti. Izjemno koristni sta lahko tudi v procesu identifikacije. Kljub številnim prednostim pa se v praksi še vedno ne izvajata v zadovoljivem obsegu, ker metodologija še ni potrjena, študije, ki se ukvarjajo s pravnimi in praktičnimi posledicami teh metod, pa so redke. V tem članku so opisana temeljna načela in prednosti metodologije, preučevana so pravna in praktična vprašanja ter predstavljen primer virtualne obdukcije v praksi na mumificiranih ostankih sv. Ivana Olinija iz cerkve sv. Blaža v Vodnjanu (Hrvaška).

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Forensic postmortem computed tomography: volumetric measurement of the heart and liver

Cited by 14 publications

References 15 publications

Cardiac hypertrophy at autopsy

Cardiac hypertrophy at autopsy

Evaluation of the mediastinal-thoracic volume ratio on postmortem computed tomography

Virtual autopsy in legal medicine: literature review and example of application on the mummified remains

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