Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study
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Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study. / Grabherr, Silke; Heinemann, Axel; Vogel, Hermann; Rutty, Guy; Morgan, Bruno; Woźniak, Krzysztof; Dedouit, Fabrice; Fischer, Florian; Lochner, Stefanie; Wittig, Holger; Guglielmi, Giuseppe; Eplinius, Franziska; Michaud, Katarzyna; Palmiere, Cristian; Chevallier, Christine; Mangin, Patrice; Grimm, Jochen M.
in: RADIOLOGY, Jahrgang 288, Nr. 1, 07.2018, S. 270-276.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study
AU - Grabherr, Silke
AU - Heinemann, Axel
AU - Vogel, Hermann
AU - Rutty, Guy
AU - Morgan, Bruno
AU - Woźniak, Krzysztof
AU - Dedouit, Fabrice
AU - Fischer, Florian
AU - Lochner, Stefanie
AU - Wittig, Holger
AU - Guglielmi, Giuseppe
AU - Eplinius, Franziska
AU - Michaud, Katarzyna
AU - Palmiere, Cristian
AU - Chevallier, Christine
AU - Mangin, Patrice
AU - Grimm, Jochen M
PY - 2018/7
Y1 - 2018/7
N2 - Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant). Results Among 18 654 findings, autopsies helped to identify 61.3% (11 433 of 18 654), postmortem CT helped to identify 76.0% (14 179 of 18 654), and postmortem CT angiography helped to identify 89.9% (16 780 of 18 654; P < .001). Postmortem CT angiography was superior to autopsy, especially at helping to identify essential skeletal lesions (96.1% [625 of 650] vs 65.4% [425 of 650], respectively; P < .001) and vascular lesions (93.5% [938 of 1003] vs 65.3% [655 of 1003], respectively; P < .001). Among the forensically essential findings, 23.4% (1029 of 4393) were not detected at autopsy, while only 9.7% (428 of 4393) were missed at postmortem CT angiography (P < .001). The best results were obtained when postmortem CT angiography was combined with autopsy. Conclusion Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method. More lesions were identified by combining postmortem CT angiography and autopsy, which may increase the quality of postmortem diagnosis. Online supplemental material is available for this article.
AB - Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant). Results Among 18 654 findings, autopsies helped to identify 61.3% (11 433 of 18 654), postmortem CT helped to identify 76.0% (14 179 of 18 654), and postmortem CT angiography helped to identify 89.9% (16 780 of 18 654; P < .001). Postmortem CT angiography was superior to autopsy, especially at helping to identify essential skeletal lesions (96.1% [625 of 650] vs 65.4% [425 of 650], respectively; P < .001) and vascular lesions (93.5% [938 of 1003] vs 65.3% [655 of 1003], respectively; P < .001). Among the forensically essential findings, 23.4% (1029 of 4393) were not detected at autopsy, while only 9.7% (428 of 4393) were missed at postmortem CT angiography (P < .001). The best results were obtained when postmortem CT angiography was combined with autopsy. Conclusion Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method. More lesions were identified by combining postmortem CT angiography and autopsy, which may increase the quality of postmortem diagnosis. Online supplemental material is available for this article.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Autopsy
KW - Cause of Death
KW - Computed Tomography Angiography
KW - Europe
KW - Female
KW - Forensic Pathology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Reproducibility of Results
KW - Young Adult
KW - Comparative Study
KW - Journal Article
KW - Multicenter Study
U2 - 10.1148/radiol.2018170559
DO - 10.1148/radiol.2018170559
M3 - SCORING: Journal article
C2 - 29714682
VL - 288
SP - 270
EP - 276
JO - RADIOLOGY
JF - RADIOLOGY
SN - 0033-8419
IS - 1
ER -
