Postmortem imaging of blood and its characteristics using MSCT and MRI

Abstract

The rapid development of computed tomography (CT) and magnetic resonance imaging (MRI) led to the introduction and establishment in postmortem investigations. The objectives of this preliminary study were to describe the imaging appearances of the early postmortem changes of blood after cessation of the circulation, such as sedimentation, postmortem clotting, and internal livores, and to give a few first suggestions on how to differentiate them from other forensic findings. In the Virtopsy project, 95 human corpses underwent postmortem imaging by CT and MRI prior to traditional autopsy and therefore 44 cases have been investigated in this study. Postmortem alterations as well as the forensic relevant findings of the blood, such as internal or subcutaneous bleedings, are presented on the basis of their imaging appearances in multislice CT and MRI.

Essentials of forensic post-mortem MR imaging in adults

“…22,23 This results in a distinctive fluid-fluid level on T 2 weighted PMMR images: cellular components of blood settle in the dependent areas of vascular structures or haemorrhagic collections as a dark hypointense layer, whereas the bright hyperintense fluid components are seen in a non-dependent position (Figure 2a). 6,19 This appearance may be disturbed by the presence of post-mortem clots, which often are of mixed to intermediate signal intensity on T 2 weighted images (Figure 2b).…”

“…6,19 This appearance may be disturbed by the presence of post-mortem clots, which often are of mixed to intermediate signal intensity on T 2 weighted images (Figure 2b). 5,19,23 Position-dependent sedimentation is also visible in the lungs 6,18,19 and can obscure or be confounded by the presence of underlying pulmonary pathology (Figure 2c). …”

Leptospira antibodies were present in the plasma part of a post-mortem clot

“…Red part is due to red blood cells and yellow part is due to plasma [3]. Post-mortem clots are not used for investigations because of the solid nature.…”

The future of pediatric and perinatal postmortem imaging

“…Contrast resolution of MRI is valuable in characterizing fluid effusions, especially blood-containing ones (15) and solid organ injuries. The disadvantages are artefacts caused by metallic foreign bodies, theoretical risk of secondary displacement of ferromagnetic foreign bodies, and the reduced availability of machines.…”