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Published on: September 8, 2023
False positive aortic dissection on postmortem computed tomography
Isabelle Le Blanc-Louvry1, Sophie Thureau1, Kathy Ledoux1
1Department of Forensic Medicine, Rouen University Hospital-Charles Nicolle, 1 rue de Germont, 76031 Rouen Cedex, France.
Unlabelled:
Post-mortem CT-scan (PMCT) has become increasingly useful as a diagnostic tool. However, certain normal postmortem changes may mimic the appearance of pathologic findings. We report two cases of false positive aortic dissection.
Methods:
Non-contrast PMCT was performed on a sixty-four-detector row scanner. Each PMCT examination was assessed and reported by two independent radiologists. Autopsies were performed according European recommendations.
Cases:
In two corpses, a false positive DeBakey type I aortic dissection was detected. Autopsies confirmed that CT findings were artifactual. For each case the cause of the mistake was individually discussed and mainly based on the abnormalities observed during the autopsy. In fact, in our series (750 PMCT) a true aortic dissection was detected in two corpses during the same period.
Conclusion:
When a PMCT is performed, false positive aortic dissection can occur, which confirms the interest in combining opacification.
Insights
Post-mortem CT-scans (PMCT) can misdiagnose aortic dissection due to normal postmortem changes. Autopsies revealed these findings were artifactual, highlighting the need for careful interpretation in forensic radiology.
Area of Science:
- Forensic Radiology
- Medical Imaging
Background:
- Post-mortem CT-scan (PMCT) is a valuable diagnostic tool in forensic investigations.
- Interpreting PMCT requires distinguishing between true pathology and postmortem artifacts.
Observation:
- Two cases presented with false positive DeBakey type I aortic dissection on non-contrast PMCT.
- Autopsies confirmed the CT findings were artifactual, not true aortic dissections.
Findings:
- Normal postmortem changes can mimic serious pathologies like aortic dissection on PMCT.
- The false positives were attributed to specific artifactual abnormalities observed during autopsy.
Implications:
- Radiologists must be aware of potential artifacts in PMCT that can lead to misdiagnosis.
- Combining PMCT with other techniques, such as opacification, may improve diagnostic accuracy for aortic pathology.
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