Postmortem CT scan in intoxication cases: A necessity or just an indulgence.

Area of Science:

• Forensic Pathology
• Radiology
• Toxicology

Background:

• Postmortem computed tomography (CT) is increasingly used in forensic investigations.
• Urinary bladder distension and pulmonary edema are potential postmortem indicators of intoxication.
• Correlation with toxicology is crucial for validating these findings.

Purpose of the Study:

• To correlate postmortem CT findings of urinary bladder distension and pulmonary edema with toxicology results.
• To assess the diagnostic value of these imaging findings in identifying alcohol and drug of abuse (DoA) intoxication.

Main Methods:

• Retrospective analysis of 434 postmortem cases from 2016.
• Inclusion of cases with blood/urine toxicology for alcohol and/or DoA.
• Recording of postmortem lung findings and urinary bladder volume (UBV) on CT scans.

Main Results:

• A statistically significant correlation was found between urinary bladder distension on CT and positive alcohol detection.
• Sensitivity for bladder distension was 51.7% and specificity was 75%.
• Pulmonary edema showed low sensitivity (52.7%) for alcohol/DoA intoxication.
• Combining both indicators improved sensitivity to 73.3% but lowered specificity to 53.8%.

Conclusions:

• Postmortem CT findings of bladder distension and pulmonary edema may suggest intoxication.
• Neither finding alone is a definitive indicator of alcohol or DoA intoxication.
• Combined indicators show potential but require further validation due to moderate specificity.