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. 2013:2013:327903.
doi: 10.1155/2013/327903. Epub 2013 Sep 4.

Postmortem computed tomography imaging in the investigation of nontraumatic death in infants and children

Yukihiro Noda  1 , Ken Yoshimura, Shoji Tsuji, Atsushi Ohashi, Hirohide Kawasaki, Kazunari Kaneko, Shigeki Ikeda, Hiroaki Kurokawa, Noboru Tanigawa
Affiliations

Postmortem computed tomography imaging in the investigation of nontraumatic death in infants and children

Yukihiro Noda et al. Biomed Res Int. 2013.

Abstract

Objective: To determine the accuracy of postmortem computed tomography (PMCT) for the assessment of causes in nontraumatic deaths in children.

Study design: We enrolled cases of nontraumatic deaths of infants and children who underwent PMCT at a single center. The presumed cause of death determined by PMCT was prospectively compared with the clinical and pathological diagnoses of deaths.

Results: Thirty-eight cases were enrolled for analysis. Among them, seven cases also underwent conventional medical autopsy. PMCT revealed an identifiable cause of death in accordance with the clinical diagnosis of death in 16 cases of the 38 cases (the concordance rate was 42%) and in accordance with the autopsy cause of death in four of the seven autopsy cases (the concordance rate was 57%). Among eight cases with unknown cause of death by clinical diagnosis, four cases (50%) were identified with cardiac tamponade as a cause of death (one case) and intracranial hemorrhage suggesting abuse (3 cases).

Conclusions: PMCT seems to be a promising technique that might serve as a substitute for conventional medical autopsy and give us the complementary information to clinical diagnoses particularly in cases of child abuse. Larger multicenter trials are worthwhile to validate the general feasibility of PMCT.

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Figures

Figure 1
Figure 1
Study protocol. PMCT: postmortem computed tomography.
Figure 2
Figure 2
Concordance between postmortem examinations. Causes of death were compared between clinical diagnoses, PMCT, and conventional autopsy. Concordance between postmortem examinations, open circles; discordance between postmortem examinations, filled circles. PMCT: postmortem computed tomography.
Figure 3
Figure 3
PMCT images of a 1-year-old boy with cardiopulmonary arrest. (a) Axial cranial PMCT image indicating subdural hemorrhage (long arrows) with subcutaneous hematoma (short arrow); (b) axial cranial PMCT image denoting occipital skull fracture (arrow). PMCT: postmortem computed tomography.
See this image and copyright information in PMC

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