Lung density measurement in postmortem computed tomography: a new tool to assess immediate neonatal breath in suspected neonaticides.


Journal

International journal of legal medicine
ISSN: 1437-1596
Titre abrégé: Int J Legal Med
Pays: Germany
ID NLM: 9101456

Informations de publication

Date de publication:
May 2020
Historique:
received: 11 01 2019
accepted: 13 06 2019
pubmed: 10 7 2019
medline: 4 2 2021
entrez: 10 7 2019
Statut: ppublish

Résumé

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. 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. 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. 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). PMCT and especially lung CT attenuation measurement is a reliable and easy-to-use method for assessing neonatal breath in suspected neonaticides.

Identifiants

pubmed: 31286205
doi: 10.1007/s00414-019-02103-3
pii: 10.1007/s00414-019-02103-3
doi:

Substances chimiques

Gases 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1159-1166

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Auteurs

Mathilde Ducloyer (M)

Forensic Medicine Department, Centre Hospitalier Universitaire de Nantes, 30 Boulevard Jean Monnet, 44000, Nantes, France. Mathilde.ducloyer@chu-nantes.fr.
Department of Radiology, Centre Hospitalier Universitaire de Nantes, Nantes, France. Mathilde.ducloyer@chu-nantes.fr.

Lucile Tuchtan (L)

Forensic Medicine Department, APHM, Hopital de la Timone, Marseille, France.
CNRS, EFS, ADES, Aix Marseille Université, Marseille, France.

Clémence Delteil (C)

Forensic Medicine Department, APHM, Hopital de la Timone, Marseille, France.
CNRS, EFS, ADES, Aix Marseille Université, Marseille, France.

Marie-Dominique Piercecchi (MD)

Forensic Medicine Department, APHM, Hopital de la Timone, Marseille, France.
CNRS, EFS, ADES, Aix Marseille Université, Marseille, France.

Arthur David (A)

Department of Radiology, Centre Hospitalier Universitaire de Nantes, Nantes, France.

Guillaume Visseaux (G)

Forensic Medicine Department, Centre Hospitalier Universitaire de Nantes, 30 Boulevard Jean Monnet, 44000, Nantes, France.

Renaud Bouvet (R)

Forensic Medicine Department, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, IDPSP EA 4640, Rennes, France.

Guillaume Gorincour (G)

Laboratoire d'Imagerie Interventionnelle et Expérimentale, LiiE, EA4264, Aix Marseille Université, Marseille, France.

Renaud Clement (R)

Forensic Medicine Department, Centre Hospitalier Universitaire de Nantes, 30 Boulevard Jean Monnet, 44000, Nantes, France.

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