Performance of post-mortem CT compared to autopsy in children

Krentz, Beatriz V.; Alamo, Leonor; Grimm, Jochen; Bruguier, Christine; Chevallier, Coralie; Egger, Coraline; Silva, Luiz F F da; Grabherr, Silke

doi:10.1007/s00414-016-1370-z

Cited by 41 publications

(31 citation statements)

References 29 publications

(46 reference statements)

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“…Recent literature indicates that the combined PMCT and PMMR provided the best noninvasive method of cause of death determinations compared to conventional autopsy. Minimally invasive studies of combined PMCT, PMCTA, and biopsies have the greatest sensitivity for cause of death determinations compared to conventional autopsy . Research on imaging alternatives to conventional autopsy will focus on reducing the cost and time of imaging autopsies in hopes of increasing the rate of imaging autopsy …”

Section: Use Of Forensic Radiology and Imaging In Medicinementioning

confidence: 99%

Forensic Radiology and Imaging for Veterinary Radiologists

Watson

Heng

2017

Vet Radiology Ultrasound

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Imaging studies are often of evidentiary value in medicolegal investigations involving animals and the role of the veterinary radiologist is to interpret those images for courts as an expert or opinion witness. With progressing interest in prosecuting animal crimes and strengthening of penalties for crimes against animals, the participation of veterinary radiologists in medicolegal investigations is expected to increase. Veterinary radiologists who are aware of radiographic and imaging signs that result in animal suffering, abuse, or neglect; knowledgeable in ways radiology and imaging may support cause of death determinations; conversant in postmortem imaging; comfortable discussing mechanisms and timing of blunt or sharp force and projectile trauma in imaging; and prepared to identify mimics of abuse can assist court participants in understanding imaging evidence. The goal of this commentary review is to familiarize veterinary radiologists with the forensic radiology and imaging literature and with the advantages and disadvantages of various imaging modalities utilized in forensic investigations. Another goal is to provide background information for future research studies in veterinary forensic radiology and imaging.

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Section: Use Of Forensic Radiology and Imaging In Medicinementioning

confidence: 99%

Forensic Radiology and Imaging for Veterinary Radiologists

Watson

Heng

2017

Vet Radiology Ultrasound

View full text Add to dashboard Cite

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“…The main differences between our recommendations and the published literature include methods by which whole-body coverage is achieved, and image slice thickness. For body coverage, some papers report imaging from vertex to feet [ 8 ], others from vertex to pelvis [ 5 ]; some image the head and body separately [ 3 , 4 , 10 ] or individual body areas, as required [ 13 ]. For simplicity and ease of adopting this protocol, we recommend imaging the entire body (from vertex to extremities) in a single examination, rather than imaging the head and neck in one examination and the thorax, abdomen, pelvis and lower limbs as a second separate examination.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly useful where sanitised images are required for a jury in medicolegal proceedings, or to show family members when explaining the cause of death [ 6 ]. Although few publications relate to the diagnostic accuracy rates of paediatric postmortem CT, those published report reasonable concordance rates with autopsy of between 57.1% and 83.3% [ 4 , 5 , 7 , 8 ], particularly for musculoskeletal abnormalities such as fractures.…”

Section: Introductionmentioning

confidence: 99%

Joint European Society of Paediatric Radiology (ESPR) and International Society for Forensic Radiology and Imaging (ISFRI) guidelines: paediatric postmortem computed tomography imaging protocol

et al. 2019

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Postmortem CT for investigating childhood deaths is increasingly utilised as a noninvasive adjunct or alternative to standard autopsy; however there are no standardised published imaging protocols. This article describes a standardised imaging protocol that has been developed based on current practices of international postmortem imaging practitioners and experts. This recommendation is expected to be useful for postmortem imaging centres wishing to update their existing practices and for those starting paediatric postmortem CT as a new service.

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“…Following the most recent advances, CT technology is today frequently requested as a complement before conventional autopsy, or in some cases as a supplement, for non-invasive post-mortem diagnosis [2][3][4]. PMCT offers a detailed visualization of anatomical structures, injury patterns or localization of foreign bodies prior to dissection [5], allowing the study of body parts or areas that are not routinely dissected during a standard autopsy, such as the viscerocranium, craniocervical junction, larynx, shoulder girdle, pelvis, extremities and soft tissue of the back [6][7][8][9]. Furthermore, while the traditional autopsy determines a destruction of the residual findings, PMCT allows preserving images for re-evaluation and reinterpretation over…”

Section: Introductionmentioning

confidence: 99%

Post-mortem computed tomography (PMCT) radiological findings and assessment in advanced decomposed bodies

et al. 2019

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The aim of the study is to report radiological findings and features in advanced decomposed bodies obtained by post-mortem computed tomography (PMCT) with autopsy correlation. Materials and methods This retrospective descriptive multicentric study included 41 forensic cases examined between May 2013 and November 2016. All the bodies were PMCT-scanned prior to autopsy, and internal putrefactive state was determined using the radiological alteration index (RAI) by a radiologist with expertise in forensic radiology and a forensic pathologist trained in forensic imaging. After PMCT scans, grade of external putrefaction (GEP) was assigned during the external examination and the complete autopsy was performed by forensic pathologists. Results The PMCT images evaluation revealed that the RAI index was > 61 in all bodies, corresponding to a moderatemassive presence of putrefactive gas. The gas grade was > II in correspondence of the major vessels, heart cavities, liver parenchyma, vertebra L3 and subcutaneous pectoral tissues, and varied from I to III in correspondence of the kidney. Cadaveric external examination revealed the presence of advanced transformative phenomena, with a GEP3 and GEP4 in most of the cases, with body swelling, eyes and tongue protrusion, body fluids expulsion and fat liquefaction. Conclusion Radiological imaging by PMCT as an adjunct to autopsy in advanced decomposed bodies represents a useful tool in detecting post-mortem gas, even in very small amounts. A correct interpretation process of the PMCT data is essential to avoid images pitfalls, due to natural decomposition that can be mistaken for pathologic processes.

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Performance of post-mortem CT compared to autopsy in children

Abstract: Up to today, very rare literature exists concerning PMCT in children, especially in a forensic setting. This article investigates the advantages and limitations of PMCT compared to autopsy in a unique study group and discusses possibilities for future developments.

Cited by 41 publications

References 29 publications

Forensic Radiology and Imaging for Veterinary Radiologists

Forensic Radiology and Imaging for Veterinary Radiologists

Joint European Society of Paediatric Radiology (ESPR) and International Society for Forensic Radiology and Imaging (ISFRI) guidelines: paediatric postmortem computed tomography imaging protocol

Post-mortem computed tomography (PMCT) radiological findings and assessment in advanced decomposed bodies

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