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Post-mortem imaging compared with autopsy in trauma victims--A systematic review.
Hamid Jalalzadeh1, Georgios F Giannakopoulos1, Ferco H Berger2
1Department of Trauma Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands; Department of General Surgery, Slotervaartziekenhuis, Louwesweg 6, 1066 EC Amsterdam, The Netherlands.
Post-mortem imaging, including CT and MRI, effectively complements conventional autopsy for trauma victims, detecting more injuries. While imaging has limitations, it can serve as an alternative when autopsy is not feasible.
Area of Science:
- Forensic pathology
- Medical imaging
- Trauma investigation
Background:
- Post-mortem imaging is a developing area for investigating trauma fatalities.
- Conventional autopsy is the standard for post-mortem examination.
- The feasibility of using imaging to supplement or replace autopsy in trauma cases requires evaluation.
Purpose of the Study:
- To review the literature on post-mortem imaging versus conventional autopsy in trauma victims.
- To assess the accuracy and limitations of different imaging modalities.
Main Methods:
- Systematic review following PRISMA guidelines.
- Searched MEDLINE, Embase, and Cochrane databases (Jan 2008-Jan 2014).
- Included studies comparing post-mortem imaging and conventional autopsy in trauma victims.
Main Results:
- 26 studies involving 563 trauma victims were analyzed.
- Post-mortem CT (PMCT) and MRI (PMMRI) accurately identified major injuries and cause of death.
- PMCT showed higher sensitivity for skeletal injuries, but autopsy remained superior for minor soft tissue/organ injuries. Aortic injuries were frequently missed by imaging.
Conclusions:
- Post-mortem CT is a valuable supplement to conventional autopsy in trauma cases, revealing additional injuries.
- Despite limitations, PMCT can be an alternative to conventional autopsy when the latter is refused or unavailable.
