Rib fractures at postmortem computed tomography (PMCT) validated against the autopsy

Schulze, Claudia; Hoppe, Hanno; Schweitzer, Wolf; Schwendener, Nicole; Grabherr, Silke; Jackowski, Christian (2013). Rib fractures at postmortem computed tomography (PMCT) validated against the autopsy. Forensic science international, 223(1-3), pp. 90-98. Elsevier Scientific Publ. Ireland 10.1016/j.forsciint.2013.08.025

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To evaluate the sensitivity of postmortem computed tomography (PMCT) in rib fracture detection validated against autopsy. Fifty-one forensic cases underwent a postmortem CT prior to forensic autopsy. Two image readers (radiologist and forensic pathologist) assessed high resolution CT data sets for rib fractures. Correct recognition rates (CRR), sensitivity and specificity values were calculated over all observations as well as individually for every rib and region. Additionally, for partial rib fractures the sensitivity of autopsy was calculated vice versa. 3876 entries in each study protocol (autopsy, PMCT radiologist and PMCT forensic pathologist) were investigated. A total of 690 fractures (autopsy), 491 (PMCT and radiologist) and 559 (PMCT and forensic pathologist) were detected. The CRR was 0.85. Sensitivity and specificity of PMCT for rib fracture detection were 0.63 (0.58 radiologist, 0.68 forensic pathologist) and 0.97 (both readers 0.97), respectively. Low CRR and sensitivity values were obtained for antero-lateral fractures. Partial rib fractures were better detected by PMCT. PMCT has a rather low sensitivity for rib fracture detection when validated against autopsy and indicates that clinical CT may also demonstrate a reasonable number of false negatives. Partial rib fractures often remain undetected at autopsy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Management
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Medicine
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Hoppe, Hanno; Schwendener, Nicole and Jackowski, Christian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0379-0738

Publisher:

Elsevier Scientific Publ. Ireland

Language:

English

Submitter:

Katrin Renfer

Date Deposited:

24 Apr 2014 11:33

Last Modified:

12 May 2014 08:59

Publisher DOI:

10.1016/j.forsciint.2013.08.025

PubMed ID:

24314506

URI:

https://boris.unibe.ch/id/eprint/44748

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