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Published on: September 27, 2020
Comparison between postmortem computed tomography and autopsy in the detection of traumatic head injuries
L Legrand1, T Delabarde2, R Souillard-Scemama3
1Service d'imagerie morphologique et fonctionnelle, centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France; Pôle universitaire d'imagerie post-mortem, Université Paris Descartes, 12, rue de l'Ecole de Médecine, 75006 Paris, France; INSERM UMR 1266, Institut de Psychiatrie et Neurosciences de Paris, 102-108 rue de la Santé, 75014 Paris, France.
Introduction:
The aim of this study was to assess the agreement between postmortem computed tomography (PMCT) and autopsy in detecting traumatic head injuries.
Materials And Methods:
Consecutive cases of death that underwent both unenhanced PMCT and conventional autopsy were collected from our institution database during a period of 3 years and reviewed retrospectively. PMCT images were reviewed for the presence of fractures (cranial vault, skull base, facial bones and atlas/axis) and intracranial hemorrhage. Kappa values were calculated to determine the agreement between PMCT and autopsy reports.
Results:
73 cases were included, of which 44 (60%) had head trauma. Agreement between PMCT and autopsy was almost perfect (κ = 0.95) for fractures and substantial (κ = 0.75) for intracranial hemorrhage. PMCT was superior to autopsy in detecting facial bone and upper cervical spine fractures, and intraventricular hemorrhage. However, in some cases thin extra-axial blood collections were missed on PMCT.
Conclusions:
The agreement between PMCT and autopsy in detecting traumatic head injuries was good. Using a combination of both techniques increases the quality of postmortem evaluation because more lesions are detected.
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