Diagnostic value of multiphase postmortem computed tomography angiography in selected cases of blunt traumatic deaths

OBJECTIVES: Recently, multiphase postmortem computed tomography angiography (MPMCTA) has been proven as a reliable tool in the diagnosis of vascular pathology, while its potential efficiency in the detection of soft tissue lesions is ignored. In this study, we have evaluated the overall diagnostic value of MPMCTA in the diagnosis of blunt traumatic deaths in selected cases to determine its additional advantages and limitations in order to identify its potential applications.

METHODS: This prospective study examined 14 decedents presented to the Department of Legal Medicine of Hamburg University that alleged death due to blunt trauma. For each case, MPMCTA and conventional autopsy findings were compared. Both radiological and autopsy findings are divided according to the body regions in addition to the detection of the cause of death.

RESULTS: Both MPMCTA and the conventional autopsy showed the major findings but not all findings. MPMCTA was better in the demonstration of vascular and skeletal lesions, while the diagnosis of parenchymal injury remains autopsy-dependent. The efficiency of MPMCTA for detection of haemorrhage was relatively affected by the blood amount and the location of the bleeding source. The presented MPMCTA-related artefacts interfered with the accurate diagnosis of certain injuries.

CONCLUSION: The combination of MPMCTA with conventional autopsy appears to be the gold standard for investigation of blunt traumatic deaths. Depending on the death circumstances and the expected findings, MPMCTA can be performed alone in selected cases.