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Keywords:
Radiographers, Professional issues, CT, Diagnostic procedure, Socio-economic issues, Comparative studies, Forensics, Trauma
Authors:
A. Silva, N. F. Pinto, A. F. Abrantes, L. P. Ribeiro, R. P. P. Almeida, K. B. Azevedo, J. P. Pinheiro; Faro/PT
DOI:
10.1594/ecr2017/B-1364
Results
The external examination of the body revealed multiple abrasions and bruises and a laceration of the scalp,
with large exposure of the bone (Fig. 1).
The CT scan revealed fractures of the ribs,
both humerus and left scapula consistent with violent trauma (Fig. 2).
CT images also showed the presence of liquid and spontaneously dense material in the sinuses; liquid filling of the trachea and proximal portions of the main bronchi,
with high gravitational density content in part of the subglottic respiratory lumen.
There was diffuse parenchymal densification with lung septal thickening and interlobular ground glass density overlapping (Fig. 3),
yielding a ‘crazy paving’ pattern and bilateral pleural effusion (Fig. 4).
The liquid filling of the trachea and proximal portions of the main bronchi (Fig. 5) and the pleural effusion (Fig. 6) was also showed on the MR imaging.
Internal examination detected the presence of sand throughout the lumen of the larynx,
pharynx,
trachea and oesophagus; fractures of the anterior arcs of the right ribs from second to seventh,
and of the anterior arcs of all left ribs (Fig. 7).
The right pleural cavity contained about 200 cubic centimetres of serous fluid,
and the left pleural cavity contained approximately 250 cubic centimetres of serous fluid.
In this study,
the imaging examinations were sufficient to determine the cause of death (drowning).
Both techniques viewed fluid in the thoracic cavity,
but imaging did not detect the presence of sand in the larynx,
pharynx,
trachea and oesophagus,
unlike conventional autopsy,
but detected unspecific foreign bodies.
In this parameter,
the conventional autopsy was superior.
However,
this difficulty can be easily overcome since there are software programs that enable the study of the tracheal lumen and the bronchial tree.