Abdominal trauma--sensitivity and specificity of postmortem noncontrast imaging findings compared with autopsy findings

Abstract

Objective: The aim of the study was to determine the sensitivity and specificity for typical abdominal injuries after major blunt trauma in postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).

Material: Thirty-four cases of accidental death underwent postmortem pre-autopsy MSCT and MRI. The imaging findings were correlated with the autopsy findings.

Results: Sensitivity and specificity for liver injury in computed tomography (CT) alone were 53% and 84%. In MRI, a sensitivity of 58% and a specificity of 46% were found. CT and MRI together (when either one was positive, liver-injury was considered) had a sensitivity of 73% and a specificity of 63%. For major liver lacerations (grades II-VI) a slightly higher sensitivity of 81% and a better specificity of 100% were noted. CT and MRI together showed a sensitivity of 50% for injuries of the spleen, specificity was 89%. CT and MRI together had a sensitivity of only 25% for trauma of the kidney, but a specificity of 100%.

Conclusion: A lot of cases with small organ injuries (such as superficial liver-laceration) seemed that could not be found by MSCT or by MRI, leading to a rather low sensitivity. Nevertheless, most of the life-threatening liver injuries could be detected, which is essential in forensic pathology.