Early postmortem volume reduction of adrenal gland: initial longitudinal computed tomographic study

Abstract

We aimed to confirm whether postmortem adrenal volumetric changes occur by measuring adrenal volumes on computed tomography (CT). Fifty-five adrenal glands from 28 subjects who died were included. All subjects underwent antemortem CT (AMCT) and postmortem CT (PMCT) within 94-1,191 min after death, followed by conventional autopsy. CT volumetry was performed using freely-available software. Differences between AMCT and PMCT adrenal volumes were evaluated statistically along with differences in the degree of volume change, elapsed time to PMCT, and presence of underlying malignant disease. The mean volume of the right adrenal gland decreased from 3.8 cm(3) on AMCT to 2.6 cm(3) on PMCT (P < 0.001); the left adrenal gland decreased from 4.2 cm(3) on AMCT to 3.1 cm(3) on PMCT (P < 0.001). Conventional autopsy revealed decreased intracellular lipid components in portions of the adrenal glands. No correlation between the adrenal gland reduction rate and the elapsed time from AMCT to death or from death to PMCT was observed (P = 0.99 and 0.79; P = 0.28 and 0.59 for the right and left adrenal glands, respectively). Significant differences in both the bilateral adrenal gland reduction rates and underlying malignant disease were found for the left adrenal gland (P = 0.015), but not for the right (P = 0.74). Adrenal volume reduction was observed on PMCT compared to AMCT. This highlights the need to further elucidate the mechanism of adrenal shrinkage during the agonal stage and after death. This may be explained by pathological findings of intracellular lipid depletion.

Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions

“…Postmortem computed tomography (CT) has increased in importance as an adjunct to traditional autopsy in forensic medicine ( 1 2 3 4 ). Diagnostic guidelines for postmortem imaging are being established worldwide, and postmortem CT findings in several organs have been described ( 5 6 7 8 9 10 ). Normal postmortem changes should be recognized when interpreting postmortem CT images, and it is worth understanding these routine artifacts in order to distinguish them from abnormal findings ( 11 ).…”

Post-Mortem Interval Estimation Based on Liver and Striated Muscle Computed Tomography Attenuations in Rats

“…However, there are many studies in the last few years investigating the value of post-mortem CT changes in PMI estimation (4,6,8). The thyroid (4), heart (7, 9, 10), cardiothoracic index (8), muscle (11), liver (12), spleen (13), bone (14), brain (15), central nervous system (15,16), lung (17), aorta (20) and surrenal glands (21) were studied to understand the changes during post-mortem processes in the literature. A summary of review of the related literature is presented in Table 4 (Table 4).…”

A comparison of embalming fluids on the structures and properties of tissue in human cadavers

“…Measurements of organs and tissue of human cadavers have been reported in literature (Ishida et al, ; Okuma et al, ; Takahashi et al, ). Changes have been reported such as a decrease in the size of the aorta after death and bilateral adrenal glands (Ishida et al, ; Takahashi et al, ).…”