Postmortem radiology of fatal hemorrhage: measurements of cross-sectional areas of major blood vessels and volumes of aorta and spleen on MDCT and volumes of heart chambers on MRI

Aghayev, Emin; Sonnenschein, Martin; Jackowski, Christian; Thali, Michael; Buck, Ursula; Yen, Kathrin; Bolliger, Stephan; Dirnhofer, Richard; Vock, Peter (2006). Postmortem radiology of fatal hemorrhage: measurements of cross-sectional areas of major blood vessels and volumes of aorta and spleen on MDCT and volumes of heart chambers on MRI. AJR, American journal of roentgenology, 187(1), pp. 209-15. Leesburg, Va.: American Roentgen Ray Society 10.2214/AJR.05.0222

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OBJECTIVE: Autopsy determination of fatal hemorrhage as the cause of death is often a difficult diagnosis in forensic medicine. No quantitative system for accurately measuring the blood volume in a corpse has been developed. MATERIALS AND METHODS: This article describes the measurement and evaluation of the cross-sectional areas of major blood vessels, of the diameter of the right pulmonary artery, of the volumes of thoracic aorta and spleen on MDCT, and of the volumes of heart chambers on MRI in 65 autopsy-verified cases of fatal hemorrhage or no fatal hemorrhage. RESULTS: Most cases with a cause of death of "fatal hemorrhage" had collapsed vessels. The finding of a collapsed superior vena cava, main pulmonary artery, or right pulmonary artery was 100% specific for fatal hemorrhage. The mean volumes of the thoracic aorta and of each of the heart chambers and the mean cross-sectional areas of all vessels except the inferior vena cava and abdominal aorta were significantly smaller in fatal hemorrhage than in no fatal hemorrhage. CONCLUSION: For the quantitative differentiation of fatal hemorrhage from other causes of death, we propose a three-step algorithm with measurements of the diameter of the right pulmonary artery, the cross-sectional area of the main pulmonary artery, and the volume of the right atrium (specificity, 100%; sensitivity, 95%). However, this algorithm must be corroborated in a prospective study, which would eliminate the limitations of this study. Quantitative postmortem cross-sectional imaging might become a reliable objective method to assess the question of fatal hemorrhage in forensic medicine.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Medicine 04 Faculty of Medicine > Service Sector > Institute of Legal Medicine 04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Management 04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Imaging 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
UniBE Contributor:	Aghayev, Emin, Jackowski, Christian, Thali, Michael, Yen, Kathrin, Bolliger, Stephan, Vock, Peter
ISSN:	0361-803X
ISBN:	16794178
Publisher:	American Roentgen Ray Society
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:47
Last Modified:	05 Dec 2022 14:14
Publisher DOI:	10.2214/AJR.05.0222
PubMed ID:	16794178
Web of Science ID:	000238659600035
URI:	https://boris.unibe.ch/id/eprint/19324 (FactScience: 1857)