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Postmortem whole-body MRI in traumatic causes of death


Ross, Steffen; Ebner, Lukas; Flach, Patricia; Brodhage, Rolf; Bolliger, Stephan A; Christe, Andreas; Thali, Michael J (2012). Postmortem whole-body MRI in traumatic causes of death. American Journal of Roentgenology, 199(6):1186-1192.

Abstract

OBJECTIVE: The aim of this study was to determine the sensitivity and specificity of postmortem whole-body MRI for typical injuries resulting from traumatic causes of death.
MATERIALS AND METHODS: Forty cases of accidental death were evaluated with postmortem whole-body MRI. Imaging was conducted according to a standard protocol, and each examination had an average duration of 90 minutes. The imaging findings were correlated with the autopsy findings, which served as the reference standard.
RESULTS: MRI showed the main pathologic process leading to death in 39 of the 40 cases. The sensitivity of postmortem MRI ranged from 100% (pneumothorax) to 40% (fractures of the upper extremities). In general, MRI had a high level of performance for depicting soft-tissue lesions, such as subcutaneous hematoma (e.g., galeal hematoma with a sensitivity 95%). The sensitivity of MRI was remarkably lower for lesions of the upper abdominal organs (liver, 80%; spleen, 50%; pancreas, 60%; kidneys, 66%).
CONCLUSION: Postmortem whole-body MRI had overall good performance for depicting traumatic findings in corpses and therefore may serve an important role as an adjunct to classic autopsy for the forensic examination of cases of traumatic cause of death. However, the reduced sensitivity of postmortem MRI for lacerations of the upper abdominal organs and the observed superimposition of antemortem findings and postmortem findings (e.g., in the pulmonary tissue) in this retrospective study suggest that whole-body postmortem MRI not be recommended as a replacement for classic autopsy.

Abstract

OBJECTIVE: The aim of this study was to determine the sensitivity and specificity of postmortem whole-body MRI for typical injuries resulting from traumatic causes of death.
MATERIALS AND METHODS: Forty cases of accidental death were evaluated with postmortem whole-body MRI. Imaging was conducted according to a standard protocol, and each examination had an average duration of 90 minutes. The imaging findings were correlated with the autopsy findings, which served as the reference standard.
RESULTS: MRI showed the main pathologic process leading to death in 39 of the 40 cases. The sensitivity of postmortem MRI ranged from 100% (pneumothorax) to 40% (fractures of the upper extremities). In general, MRI had a high level of performance for depicting soft-tissue lesions, such as subcutaneous hematoma (e.g., galeal hematoma with a sensitivity 95%). The sensitivity of MRI was remarkably lower for lesions of the upper abdominal organs (liver, 80%; spleen, 50%; pancreas, 60%; kidneys, 66%).
CONCLUSION: Postmortem whole-body MRI had overall good performance for depicting traumatic findings in corpses and therefore may serve an important role as an adjunct to classic autopsy for the forensic examination of cases of traumatic cause of death. However, the reduced sensitivity of postmortem MRI for lacerations of the upper abdominal organs and the observed superimposition of antemortem findings and postmortem findings (e.g., in the pulmonary tissue) in this retrospective study suggest that whole-body postmortem MRI not be recommended as a replacement for classic autopsy.

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15 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:340 Law
610 Medicine & health
Language:English
Date:2012
Deposited On:31 Jan 2013 10:01
Last Modified:05 Apr 2016 16:21
Publisher:American Roentgen Ray Society
ISSN:0361-803X
Publisher DOI:https://doi.org/10.2214/AJR.12.8767
PubMed ID:23169707

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