Longitudinal comparison of ascites attenuation between antemortem and postmortem computed tomography

Area of Science:

• Radiology
• Forensic Pathology

Background:

• Computed tomography (CT) is crucial for medical and forensic evaluations.
• Ascites, or fluid accumulation in the abdomen, can be assessed using CT.
• Understanding changes in ascites attenuation between antemortem (before death) and postmortem (after death) CT scans is important for accurate interpretation.

Purpose of the Study:

• To compare ascites attenuation measurements between antemortem CT (AMCT) and postmortem CT (PMCT) in the same individuals.
• To identify factors influencing any observed changes in ascites attenuation.

Main Methods:

• Thirty-five subjects with available AMCT and PMCT scans were analyzed.
• Ascites attenuation was measured at corresponding sites on both AMCT and PMCT.
• Data from unenhanced and enhanced CT scans were analyzed separately.
• Correlation with time interval, serum albumin, GFR, and ascites volume was assessed.

Main Results:

• Significantly higher ascites attenuation was found on PMCT compared to AMCT in enhanced scans (18.7 vs. 12.2 HU, p=0.006).
• No significant difference in ascites attenuation was observed between unenhanced AMCT and PMCT (13.4 vs. 13.5 HU, p=0.554).
• A shorter time interval between AMCT and PMCT correlated with greater attenuation changes in enhanced scans (r=-0.56, p=0.01).

Conclusions:

• Ascites attenuation increases on postmortem CT scans, particularly after contrast administration.
• The findings highlight the impact of contrast media on postmortem imaging interpretation.
• Time interval is a key factor influencing ascites attenuation changes between antemortem and postmortem imaging.