False positive aortic dissection on postmortem computed tomography.

UNLABELLED: Post-mortem CT-scan (PMCT) has become increasingly useful as a diagnostic tool. However, certain normal postmortem changes may mimic the appearance of pathologic findings. We report two cases of false positive aortic dissection. METHODS: Non-contrast PMCT was performed on a sixty-four-detector row scanner. Each PMCT examination was assessed and reported by two independent radiologists. Autopsies were performed according European recommendations. CASES: In two corpses, a false positive DeBakey type I aortic dissection was detected. Autopsies confirmed that CT findings were artifactual. For each case the cause of the mistake was individually discussed and mainly based on the abnormalities observed during the autopsy. In fact, in our series (750 PMCT) a true aortic dissection was detected in two corpses during the same period. CONCLUSION: When a PMCT is performed, false positive aortic dissection can occur, which confirms the interest in combining opacification.

Post-mortem computed tomography compared to forensic autopsy findings: a French experience.

OBJECTIVES: The principal aim of our study was to establish concordance between post-mortem CT (PMCT) and forensic standard autopsy (SA) in detecting lesions according to different anatomical regions. A secondary aim was to determine the efficacy of PMCT in showing lethal lesions. METHODS: PMCTs were compared with autopsies in 236 cadavers in different contexts of death. PMCT findings were assessed by two independent radiologists. RESULTS: Concordance between PMCT and autopsy was almost perfect in showing skull, basal skull and hyoid bone fractures as well as in detecting facial, vertebral or pelvic fractures. Both examinations were discordant in demonstrating some intracranial injuries, vascular or organ wounds (more findings showed by autopsy), as well in showing free air in anatomical cavities (more findings detected by PMCT). Moreover, PMCT was effective in determining lethal lesions in the context of craniofacial trauma or after a gunshot wound. Concordance between the findings of the two radiologists was almost perfect for each type of lesion. CONCLUSION: PMCT could be considered as effective as SA in determining the cause of death in certain traumatic events. It was also effective in showing lethal lesions and could be a useful tool in reducing the number of SA. KEY POINTS: • Post-mortem CT is increasingly performed as an alternative/adjunct to formal autopsy. • More modern CT systems provide greater anatomical scope. • PMCT can usually determine the cause of most deaths following trauma. • Prospective studies are still required to establish an algorithm for forensic CT.