Journal Article

Total-body CT and MR features of postmortem change in in-hospital deaths

Weustink, Annick C., Hunink, Myriam G., Wielopolski, Piotr A., Renken, Nomdo S., Wagensveld, Ivo M., Blokker, Britt M., Krestin, Gabriel P., Oosterhuis, J. Wolter

2017

Overview

To evaluate the frequency of total-body CT and MR features of postmortem change in in-hospital deaths. In this prospective blinded cross-sectional study, in-hospital deceased adult patients underwent total-body postmortem CT and MR followed by image-guided biopsies. The presence of PMCT and PMMR features related to postmortem change was scored retrospectively and correlated with postmortem time interval, post-resuscitation status and intensive care unit (ICU) admittance. Intravascular air, pleural effusion, periportal edema, and distended intestines occurred more frequently in patients who were resuscitated compared to those who were not. Postmortem clotting was seen less often in resuscitated patients (p = 0.002). Distended intestines and loss of grey-white matter differentiation in the brain showed a significant correlation with postmortem time interval (p = 0.001, p<0.001). Hyperdense cerebral vessels, intravenous clotting, subcutaneous edema, fluid in the abdomen and internal livores of the liver were seen more in ICU patients. Longer postmortem time interval led to a significant increase in decomposition related changes (p = 0.026). There is a wide variety of imaging features of postmortem change in in-hospital deaths. These imaging features vary among clinical conditions, increase with longer postmortem time interval and must be distinguished from pathologic changes.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Aged, 80 and over / Biology and Life Sciences / Biopsy / Blood vessels / Brain / CAT scans / Clotting / Comparative analysis / Computed tomography / Correlation analysis / Cross-Sectional Studies / Decomposition / Differentiation / Edema / Electrical impedance / Fatalities / Female / Gravity / Hospital Mortality / Hospitals / Humans / Intensive Care Units - statistics & numerical data / Intestine / Intravenous administration / Liver / Magnetic Resonance Imaging / Male / Medical imaging / Medicine and Health Sciences / Middle Aged / Neuroimaging / NMR / Nuclear magnetic resonance / Nuclear medicine / Pathology / Patients / Physical Sciences / Physicians / Pleural effusion / Postmortem Changes / Quantitative analysis / Research and Analysis Methods / Resuscitation / Substantia alba / Tomography, X-Ray Computed