Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

Abstract

ObjectiveWe prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings.Materials and MethodsFive cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings.ResultsMost of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises.ConclusionA postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations.

Essentials of forensic post-mortem MR imaging in adults

“…The literature provides strong evidence that T 2 weighted MR images are of paramount importance in post-mortem imaging: their ability to highlight fluid accumulations makes them an ideal diagnostic tool for a wide range of pathologies, including subcutaneous haematoma, bone contusion, organ laceration, internal haemorrhage and fluid collections, ischaemic injury of the heart, brain oedema, pericardial or pleural effusion and pulmonary oedema. 6,19,23,31,[39][40][41][42][43][44] In our experience, STIR sequences are most suitable for screening purposes because they emphasize the signal from tissues with long T 2 relaxation times 45 and fluid accumulations literally flash like light bulbs when scrolling through images on STIR sequences. Thus, we refer to this phenomenon as the "forensic sentinel sign" ( Figure 6).…”

“…6,9,10,88 However, the ability of PMMR to highlight bone marrow oedema on STIR sequences offers a more profound insight into the sequence of peri-mortem events than PMCT alone. 43,94,95 Buck et al 94 were the first to note the potential and occasional superiority of PMMR over PMCT in forensic case reconstruction of skeletal injury. 93 Their publication reports on a series of five traffic fatalities, where PMMR enabled the detection of bone contusions unseen on PMCT.…”

Can postmortem computed tomography detect antemortem hypoxic–ischemic encephalopathy?

“…The popularity of computed tomography (CT) as an adjunct to conventional postmortem investigation methods is increasing in the fields of clinical pathology and forensic medicine [1][2][3][4][5][6]. Postmortem CT (PMCT) provides the following information: the presence of pre-existing and pathological findings, changes related to the cause of death, nonspecific natural changes occurring in the agonal stage and/or after death, and effects of cardiopulmonary resuscitation.…”

Postmortem Whole-Body MRI in Traumatic Causes of Death

“…Studies of whole-body postmortem MRI have mainly focused on natural causes of death [4,5]. To our knowledge, there has been no systematic evaluation of the use of postmortem whole-body MRI in traumatic causes of death.…”

“…To our knowledge, there has been no systematic evaluation of the use of postmortem whole-body MRI in traumatic causes of death. The purpose of this study was to evaluate the sensitivity, specificity, and accuracy of postmortem whole-body MRI com-P ostmortem MRI has the potential to become an adjunct to or even a replacement for classic autopsy [1][2][3][4][5][6][7][8][9][10]. One of the potential advantages of whole-body postmortem MRI over classic autopsy is the possibility of reevaluating a case, even years after burial.…”