Open AccessTotal-body CT and MR features of postmortem change in in-hospital deaths
Author(s) -
Ivo M. Wagensveld,
Britt M. Blokker,
Piotr A. Wielopolski,
Nomdo S. Renken,
Gabriël P. Krestin,
M. G. Myriam Hunink,
J. Wolter Oosterhuis,
Annick C. Weustink
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0185115
Subject(s) - medicine , postmortem changes , resuscitation , autopsy , postmortem studies , intensive care unit , edema , cerebral edema , pleural effusion , abdomen , radiology , surgery , pathology
Objectives To evaluate the frequency of total-body CT and MR features of postmortem change in in-hospital deaths. Materials and methods 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. Results 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). Conclusions 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.