Clinical radiology and postmortem imaging (Virtopsy) are not the same: Specific and unspecific postmortem signs

Area of Science:

• Forensic Radiology
• Medical Imaging
• Pathology

Background:

• Postmortem imaging is increasingly used in forensic investigations.
• Clinical radiologists may encounter unfamiliar findings in postmortem computed tomography (CT).
• Understanding these signs is crucial for accurate cause-of-death determination.

Purpose of the Study:

• To detail the characteristics of postmortem forensic imaging.
• To present common and novel postmortem imaging findings.
• To discuss potential diagnostic pitfalls in postmortem CT.

Main Methods:

• Review of postmortem CT imaging characteristics.
• Categorization of findings into unspecific and specific signs.
• Correlation of imaging findings with causes of death.

Main Results:

• Unspecific signs include internal livor mortis (ground glass opacity in lungs) and aortic wall hyperdensity.
• Gas bubbles are common postmortem, especially with decomposition.
• Specific signs: intracranial hemorrhage, neck soft tissue hemorrhage (strangulation), "vanishing" aorta (exsanguination), and fluid in airways (drowning).

Conclusions:

• Postmortem imaging offers valuable insights into cause of death.
• Recognizing specific signs aids in differentiating between various causes of death.
• Awareness of pitfalls enhances the reliability of forensic imaging interpretation.