Multidetector Computed Tomography Findings in Deaths With Severe Burns

Abstract

This study compared autopsy with postmortem multidetector computed tomography (MDCT) findings in charred remains. Seventeen consecutive male subjects (mean age, 29.4 years) who perished in a fire-related event resulting in charred remains underwent total body MDCT immediately prior to routine autopsy that included serum carboxyhemoglobin measurement. MDCT showed all thermal tissue changes (skin and subcutaneous fat loss, skeletal muscle retraction, pugilistic attitude, cortical fractures, bone and organ destruction, thermal epidural hematoma, and thermal amputation) and established all fracture patterns that were lethal, but autopsy added the fire as a contributory cause of death when there was carboxyhemoglobin elevation. MDCT had limited value in determination of lethal vascular and visceral injuries. MDCT is an effective complement to autopsy in the setting of charred remains and may serve to augment a limited autopsy. This may be particularly useful in mass casualty scenarios.

Post-mortem imaging compared with autopsy in trauma victims – A systematic review

“…The time interval between death and imaging was mentioned in 16 studies and ranged widely from less than 24 h to 8 days [3,7,18,19,[22][23][24][25]28,29,31,32,[36][37][38]40]. One study also included one body 10 years after the individual's death but no quantitative results were described about this case [36].…”

“…One study also included one body 10 years after the individual's death but no quantitative results were described about this case [36]. The median time interval between death and autopsy was mentioned in seven studies and ranged from less than 24 h to 3.4 days [18,25,28,29,31,32,40].…”

“…The radiological results show a good diagnostic agreement with autopsy in regard to intracranial hemorrhages. Subarachnoid hemorrhages (SAH) and subdural [19] Occipital condyle fracture (n = 4) CT: 4 1 4.00 Daly, 2013 [19] Atlanto-occipital fracture/dislocation (n = 14) CT: 10 9 1.11 Daly, 2013 [19] C6 fracture (n = 1) CT: 1 0 >1 Daly, 2013 [19] C7 fracture (n = 1) CT: 1 0 >1 Leth, 2013 [18] C1 or C2 fracture or dislocation (n = 11) CT: 11 9 1.22 Uhrenholt, 2010 [33] C1 fracture (n = 5) CT: 4 3 1.33 Uhrenholt, 2010 [33] C2 fracture (n = 9) CT: 9 9 1.00 Levy, 2009 [31] Cervical spine fracture + dislocation (n = 1) CT: 1 1 1.00 Iwase, 2009 [34] C5 fracture CT: 1 0 >1 Sochor, 2008 [3] C2 odontoid fracture (n = 1) CT: 1 0 >1 Sochor, 2008 [3] C6 fracture (n = 1) CT: 1 0 >1…”

Post-mortem computed tomography angiography: past, present and future

“…It has been shown that MDCT has surpassed conventional radiographic techniques, especially for detailed in situ post-mortem imaging [3][4][5]. Today MDCT, and to a lesser extent MRI, are rapidly becoming the imaging modalities of choice for autopsy practice.…”

The survival of metallic residues from gunshot wounds in cremated bone: a radiological study

“…Thereby, at the moment, very little literature exists on the survival of metal residues in charred material [25][26][27][28][29].…”