Effectiveness of "Autopsy imaging" in emergency department : A clinical application of postmortem computed tomography in Japan.

Congress:

ECR 2012

Poster Number:

C-0730

Type:

Scientific Exhibit

Keywords:

Forensics, Screening, Diagnostic procedure, CT, Trauma, Forensic / Necropsy studies, Emergency

Authors:

K. Ito; Kamogawa, Chiba pref./JP

DOI:

10.1594/ecr2012/C-0730

DOI-Link:

https://dx.doi.org/10.1594/ecr2012/C-0730

$Fig. 6: 26 y.o. man was in a motor cycle accident. He had fractures of his skull. Pneumothorax, pneumocephalus, and air correction in his right atrium and ventricle were found (Arrows). Diagnoses were loss of blood and brain contusion due to traffic accident.$

Fig. 6: 26 y.o. man was in a motor cycle accident. He had fractures of his skull. ...

$Fig. 7: 73 y.o. woman was in a traffic accident. She had fracture of her facial bone and skull with deformity. The diagnosis was brain contusion due to traffic accident.$

Fig. 7: 73 y.o. woman was in a traffic accident. She had fracture of her facial bone...

Fig. 3: 62 y.o. man who had under hemodialysis due to diabetic kidney was found in...

Fig. 4: 58 y.o. farmer was found in cardio-pulmonary arrest state in his farm. Aortic...

Purpose

Recently in Japan, a decrease of forensic autopsy's in unsuspected deaths has led to an increase in performing Postmortem Computed Tomography (PMCT) in clinical fields to estimate the fatal findings related to death. The clinical application of PMCT is so called "Autopsy imaging (Ai)". Sometimes, emergency room physicians suffer from less information to make diagnoses on patients especially cardio-pulmonary arrested on arrival. The aim of this study is to evaluate the diagnostic performance of postmortem computed tomography (PMCT) in emergency department for the detection of...

Methods and Materials

1. Patients a. Inclusion criteria During March 1st, 2009 to November 30th, 2011, a patient wherein a PMCT was performed at Kameda Medical Center (Kamogawa, Chiba, JAPAN) was entered into our study. At Kameda Medical Center, PMCT studies were performed on patients who received pathological autopsy following their death, and on patient's who deceased shortly after admission to our emergency room. In these former cases, it was utilized as a screening method before autopsy and, in the latter cases, it was utilized to help determine...

Results

There were 67 eligible for the study; 41 were men, 26 were women. The mean age was 68.8 years old; range 26 to 90. PMCT could depict fatal findings related to death in 50 cases (74.6 %). There were 17 (25.4 %) cases which couldn't depict findings. (Table. 1) The internal cause of death, such as rupture of aneurysm, intracranial hemorrhage, and pneumonia, were 26 cases (38.8 %). (Table. 2) Some typical cases were shown in figure.1 to 4. The external cause such as trauma,...

Conclusion

This result meaning that PMCT will help us to give their exact diagnosis despite of less information about patients especially in cardio-pulmonary arrest state. Also, PMCT may help us to check whether our therapies were adequate or not afterwords. In conclusion, PMCT is useful not only in the law court but also in the clinical field. It has the capability to depict the fatal findings related to death in about 75 %.

References

1. Takahashi N, Higuchi T, Shiotani M et al: The effectiveness of postmortem multidetector computed tomography in the detection of fatal findings related to cause of non-traumatic death in the emergency department. Eur Radiol 2012;22:152-160. 2. Hoey BA, Cipolla J, Grossman MD et al: Postmortem computed tomography, "CATopsy", predicts cause of death in trauma patients. J Trauma 2007;63:979-985. 3. Dirnhofer R, Jackowski C, Vock P et al: VIRTOPSY: minimally invasive, imaging-guided virtual autopsy. Radiographics 2006;26:1305-1333. 4. Levy AD, Harcke HT, Getz JM et al: Virtual...

Personal Information

K.Ito. Emergency and Trauma department, Kameda medical center, 929 Higashi-Cho, Kamogawa city, Chiba pref., JAPAN Mail to: [email protected]