ABSTRACT
Purpose To determine if postmortem computed tomography (CT) and postmortem CT angiography help to detect more lesions than autopsy in postmortem examinations, to evaluate the strengths and weaknesses of each method, and to define their indications. Materials and Methods Postmortem CT angiography was performed on 500 human corpses and followed by conventional autopsy. Nine centers were involved. All CT images were read by an experienced team including one forensic pathologist and one radiologist, blinded to the autopsy results. All findings were recorded for each method and categorized by anatomic structure (bone, organ parenchyma, soft tissue, and vascular) and relative importance in the forensic case (essential, useful, and unimportant). Results Among 18 654 findings, autopsies helped to identify 61.3% (11 433 of 18 654), postmortem CT helped to identify 76.0% (14 179 of 18 654), and postmortem CT angiography helped to identify 89.9% (16 780 of 18 654; P < .001). Postmortem CT angiography was superior to autopsy, especially at helping to identify essential skeletal lesions (96.1% [625 of 650] vs 65.4% [425 of 650], respectively; P < .001) and vascular lesions (93.5% [938 of 1003] vs 65.3% [655 of 1003], respectively; P < .001). Among the forensically essential findings, 23.4% (1029 of 4393) were not detected at autopsy, while only 9.7% (428 of 4393) were missed at postmortem CT angiography (P < .001). The best results were obtained when postmortem CT angiography was combined with autopsy. Conclusion Postmortem CT and postmortem CT angiography and autopsy each detect important lesions not detected by the other method. More lesions were identified by combining postmortem CT angiography and autopsy, which may increase the quality of postmortem diagnosis. Online supplemental material is available for this article.
Subject(s)
Autopsy/methods , Cause of Death , Computed Tomography Angiography/methods , Forensic Pathology/methods , Adult , Aged , Aged, 80 and over , Autopsy/statistics & numerical data , Computed Tomography Angiography/statistics & numerical data , Europe , Female , Humans , Male , Middle Aged , Prospective Studies , Reproducibility of Results , Young AdultABSTRACT
The rising popularity of Alpine skiing in recent years has led to an increase of skiing accidents, some with fatal outcome. In this paper, all fatal skiing accidents from the autopsy material of the Institute of Forensic Medicine of the Paris Lodron University Salzburg were evaluated and compared with statistical data of the Alpine Police. In the wintertime of 2005/2006 until 2013/2014, 22 deadly skiing accidents were autopsied. The age of the male and female victims ranged between 12 and 71 years. The main cause of death was craniocerebral and chest trauma. A relevant blood alcohol concentration was detected in only one case. Together with trauma-biomechanical and technical experts, forensic medicine serves as a necessary clarification interface between the investigating authorities and the judiciary. Determining the cause and manner of death as well as reconstructing the accident is the main task of the forensic pathologist. The present study shows that in the county of Salzburg, only a small percentage of fatal skiing accidents is evaluated from a forensic and trauma-biomechanical point of view. Thus the possibilities of an interdisciplinary accident analysis are not always fully utilized.
