Injuries of the isolated larynx-hyoid complex in post-mortem computed tomography (PMCT) and post-mortem fine preparation (PMFP) - a comparison of 54 forensic cases.
Adolescent
Adult
Aged
Aged, 80 and over
Autopsy
Cause of Death
Cohort Studies
Female
Forensic Medicine
/ methods
Fractures, Bone
/ diagnostic imaging
Humans
Hyoid Bone
/ diagnostic imaging
In Vitro Techniques
Larynx
/ diagnostic imaging
Male
Middle Aged
Multidetector Computed Tomography
/ methods
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Young Adult
Autopsy
Larynx
Multidetector computed tomography
Neck injuries
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
27
09
2019
accepted:
21
02
2020
revised:
19
12
2019
pubmed:
2
4
2020
medline:
5
1
2021
entrez:
2
4
2020
Statut:
ppublish
Résumé
To assess the diagnostic accuracy (ACC) of post-mortem computed tomography (PMCT) for fractures of the isolated larynx-hyoid complex (LHC) in comparison to post-mortem fine preparation (PMFP). This monocentric prospective study enclosed 54 LHCs that were extracted during autopsy, fixed in formalin, and underwent a PMCT scan (64-row multidetector CT, helical pitch). Two radiologists independently analyzed the LHC scans for image quality (IQ) and fractures (4-point Likert scales). A specialized forensic preparator dissected the specimens under the stereomicroscope. The PMFP results were standardized documented, and used as the standard of reference for the comparison to PMCT. The PMCT-IQ of 95% of the LHC images was rated as good or excellent. IQ was decreased by decay, incisions during autopsy, and separation of the hyoid from the cartilaginous components in 7, 3, and 12 specimens, respectively. PMFP detected 119 fractures in 34 LHCs (63.0%). PMCT identified 91 fractures in 32 specimens (59.3%). PMFP and PMCT significantly agreed concerning the location (Cohen's κ = 0.762; p < 0.001) and the degree of dislocation (κ = 0.689; p < 0.001) of the fractures. Comparing PMCT to PMFP resulted in a sensitivity of 88.2%, a specificity of 90.0%, and an ACC of 88.9% for the LHC. The ACCs for the hyoid, thyroid, and cricoid were 94.4%, 87.0%, and 81.5%, respectively. PMCT procedure was significantly faster than PMFP (28.9 ± 4.1 min vs. 208.2 ± 32.5 min; p < 0,001). PMCT can detect distinct injuries of the isolated LHC and may promptly confirm violence against the neck as cause of death. PMFP outmatches PMCT in the detection of decent injuries like tears of the cricoid cartilage. • Post-mortem computed tomography is able to assess fractures of the larynx-hyoid complex. • Prospective monocentric in vitro study showed that post-mortem computed tomography of the larynx-hyoid complex is faster than post-mortem fine preparation. • Post-mortem computed tomography can confirm violence against the neck as cause of death.
Identifiants
pubmed: 32232789
doi: 10.1007/s00330-020-06770-4
pii: 10.1007/s00330-020-06770-4
pmc: PMC8275497
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4564-4572Commentaires et corrections
Type : ErratumIn
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