Distribution of artifactual gas on post-mortem multidetector computed tomography (MDCT)

Area of Science:

• Forensic Radiology
• Post-mortem Imaging
• Pathology

Background:

• Distinguishing post-mortem gas artifact from vital air embolism is crucial in forensic investigations.
• Multidetector computed tomography (MDCT) is increasingly used for post-mortem imaging.

Purpose of the Study:

• To investigate the incidence and distribution of post-mortem gas detected by MDCT.
• To identify factors distinguishing artifactual gas from cardiac air embolism.

Main Methods:

• Retrospective analysis of MDCT data from 119 cadavers.
• Semiquantitative assessment of gas in 82 specific anatomical sites.

Main Results:

• Gas was detected in 62.2% of cadavers, with 75.7% showing gas in the heart.
• Common sites included hepatic parenchyma, right heart, inferior vena cava, hepatic veins, and portal spaces.
• A large amount of right heart gas associated with hepatic parenchymal gas strongly indicated putrefaction (100% sensitivity, 89.7% specificity).

Conclusions:

• Post-mortem gas exhibits a characteristic distribution pattern.
• The association between intracardiac and hepatic parenchymal gas can differentiate post-mortem gas from vital air embolism.
• This finding offers a key diagnostic marker for death due to cardiac air embolism.