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The cardiothoracic ratio on post-mortem computer tomography.

M Jotterand1, F Doenz2, S Grabherr3

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Summary
This summary is machine-generated.

The cardiothoracic ratio (CTR) on post-mortem CT (PMCT) can aid in diagnosing cardiomegaly. However, heart dilatation and BMI can affect CTR, and scout views may overestimate measurements.

Keywords:
CardiomegalyCardiothoracic ratioHeart dilatationPost-mortem CT scanner PMCT

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Area of Science:

  • Forensic Radiology
  • Cardiovascular Pathology

Background:

  • The cardiothoracic ratio (CTR) is a standard metric for diagnosing cardiomegaly in clinical settings using radiography and CT.
  • Its application in forensic practice on post-mortem CT (PMCT) could enable pre-autopsy detection of cardiomegaly, but requires threshold adaptation due to post-mortem changes.

Purpose of the Study:

  • To measure CTR on PMCT and evaluate the influence of variables like heart dilatation and body mass index (BMI).
  • To assess the concordance between different measurement views (axial vs. scout) and between forensic and radiology readers.

Main Methods:

  • Retrospective analysis of 109 autopsy cases with normal heart weight.
  • Independent CTR measurements by a forensic pathologist and a radiologist on axial and scout views of PMCT.
  • Statistical analysis to test inter-reader reliability, inter-view concordance, and association with variables.

Main Results:

  • CTR measurements were overestimated on scout views compared to axial views.
  • High inter-reader correlation was observed for both views.
  • Heart dilatation and BMI were significantly associated with increased CTR.

Conclusions:

  • CTR is a potentially useful tool for diagnosing cardiomegaly on PMCT.
  • Acute heart failure-induced cardiac chamber dilatation may mimic cardiomegaly radiographically.
  • High inter-observer reliability was confirmed, but scout view overestimation and the impact of cardiac hypertrophy require further investigation.