Early postmortem volume reduction of adrenal gland: initial longitudinal computed tomographic study

Area of Science:

• Forensic pathology
• Radiology
• Endocrinology

Background:

• Adrenal gland volume changes after death are not well-documented.
• Computed tomography (CT) is a valuable tool for volumetric analysis.

Purpose of the Study:

• To quantify postmortem adrenal volumetric changes using CT.
• To investigate factors influencing these changes, such as time since death and malignancy.

Main Methods:

• CT scans from 28 deceased subjects (55 adrenal glands) were analyzed.
• Antemortem CT (AMCT) and postmortem CT (PMCT) volumes were compared.
• Statistical analysis evaluated volume differences, time intervals, and presence of malignant disease.

Main Results:

• Significant adrenal gland volume reduction was observed between AMCT and PMCT for both right (3.8 to 2.6 cm³) and left (4.2 to 3.1 cm³) glands (P < 0.001).
• Autopsy revealed decreased intracellular lipids in adrenal glands.
• No correlation was found between reduction rate and time to PMCT; however, the left adrenal gland showed significant differences related to malignancy (P = 0.015).

Conclusions:

• Postmortem adrenal glands exhibit a measurable volume reduction compared to antemortem scans.
• Intracellular lipid depletion is a potential mechanism for this observed shrinkage.
• Further research is needed to understand the dynamics of adrenal gland volume changes during the agonal period and postmortem.