Block-like and cast-like hyperdense areas in the right heart cavities on post-mortem CT strongly suggest the presence of intracardiac blood clots at autopsy.


Journal

European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 13 11 2020
accepted: 06 05 2021
revised: 25 03 2021
pubmed: 9 6 2021
medline: 17 11 2021
entrez: 8 6 2021
Statut: ppublish

Résumé

To classify the types of hyperdense areas in the heart cavities on post-mortem CT (PMCT) and compare them according to the presence of blood clots in the heart cavities at forensic autopsy. One hundred and twelve cases with CT images taken before forensic autopsy were evaluated. The presence and shape of hyperdense areas in the right or left heart cavities were retrospectively evaluated on PMCT images and were classified into four types (block-like, cast-like, fluid level-like, and unclear). The presence of blood clots was confirmed when there were clots in the heart cavities at forensic autopsy. Of the 112 cases, 57 exhibited blood clots in the heart cavities at forensic autopsy. The hyperdense areas in the right heart cavities on PMCT in 57 cases exhibiting blood clots at forensic autopsy were classified as follows: block-like, 32; fluid level-like, 4; cast-like, 17; and unclear, 4. The sensitivity of block-like and cast-like hyperdense areas in the right heart cavities on PMCT for the presence of clots in the heart cavities at forensic autopsy was 86% (95% confidence interval [CI]: 74-94%); the corresponding specificity, PPV, and NPV were 95% (95% CI: 85-99%), 94% (95% CI: 84-99%), and 87% (95% CI: 75-94%), respectively. Block-like and cast-like hyperdense areas in the right heart cavities on PMCT predicted the presence of intracardiac blood clots at forensic autopsy. • Clinical radiologists likely have no experience of interpreting findings of blood clots on post-mortem CT (PMCT). • The appearance of blood clots on PMCT provides important clues for diagnosing the cause and process of death. • The shapes of the hyperdense areas in the heart cavities were classified into four types, and two of these types could be used to predict the presence of blood clots in the heart cavities at forensic autopsy.

Identifiants

pubmed: 34100997
doi: 10.1007/s00330-021-08052-z
pii: 10.1007/s00330-021-08052-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

8879-8886

Informations de copyright

© 2021. European Society of Radiology.

Références

Poulsen K, Simonsen J (2007) Computed tomography as routine in connection with medico-legal autopsies. Forensic Sci Int 171:190–197
doi: 10.1016/j.forsciint.2006.05.041
Dirnhofer R, Jackowski C, Vock P, Potter K, Thali MJ (2006) VIRTOPSY: minimally invasive, imaging-guided virtual autopsy. Radiographics 26:1305–1333
doi: 10.1148/rg.265065001
Bolliger SA, Thali MJ, Ross S, Buck U, Naether S, Vock P (2008) Virtual autopsy using imaging: bridging radiologic and forensic sciences. A review of the Virtopsy and similar projects. Eur Radiol 18:273–282
doi: 10.1007/s00330-007-0737-4
Christe A, Flach P, Ross S et al (2010) Clinical radiology and postmortem imaging (Virtopsy) are not the same: specific and unspecific postmortem signs. Leg Med (Tokyo) 12:215–222
Usui A, Kawasumi Y, Hosokai Y, Hayashizaki Y, Funayama M, Saito H (2012) Usefulness of postmortem computed tomography before forensic autopsy for alerting forensic personnel to tuberculosis infection. Jpn J Radiol 30:612–615
doi: 10.1007/s11604-012-0096-1
Jackowski C, Thali M, Aghayev E et al (2006) Postmortem imaging of blood and its characteristics using MSCT and MRI. Int J Leg Med 120:233–240
doi: 10.1007/s00414-005-0023-4
Hansma P, Powers S, Diaz F, Li W (2015) Agonal thrombi at autopsy. Am J Forensic Med Pathol 36:141–144
doi: 10.1097/PAF.0000000000000162
Both IV, Bruni SG, Herath JC (2018) Differentiation of antemortem pulmonary thromboembolism and postmortem clot with unenhanced MRI: a case report. Forensic Sci Med Pathol 14:95–101
doi: 10.1007/s12024-017-9940-z
Kawasumi Y, Onozuka N, Kakizaki A et al (2013) Hypothermic death: possibility of diagnosis by post-mortem computed tomography. Eur J Radiol 82:361–365
doi: 10.1016/j.ejrad.2012.11.017
O’Donnell C, Woodford N (2008) Post-mortem radiology – a new sub-speciality? Clin Radiol 63:1189–1194
doi: 10.1016/j.crad.2008.05.008
Huisman TA (2004) Magnetic resonance imaging: an alternative to autopsy in neonatal death? Semin Neonatol 9:347–353
doi: 10.1016/j.siny.2003.09.004

Auteurs

Akito Kasagawa (A)

Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

Akihito Usui (A)

Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. t7402r0506@med.tohoku.ac.jp.

Yusuke Kawasumi (Y)

Department of Clinical Imaging, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

Masato Funayama (M)

Department of Forensic Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

Haruo Saito (H)

Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

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