Estimation of Postcardiac Arrest Interval Based on Atrial Cavity Density in Postmortem Computed Tomography

Area of Science:

• Forensic radiology
• Postmortem imaging analysis
• Cardiovascular pathology

Background:

• Intracardiac hypostasis is a common finding in postmortem CT scans, becoming more apparent with increased postmortem interval.
• Accurate estimation of the post-cardiac arrest interval (PCAI) is crucial in forensic investigations.

Purpose of the Study:

• To evaluate the utility of atrial densities in postmortem computed tomography (PMCT) for determining the post-cardiac arrest interval (PCAI).
• To investigate the correlation between the densities of the right atrium anterior part (AR) and left atrium posterior part (PL) and the PCAI.

Main Methods:

• A study included 184 patients, excluding those with return of spontaneous circulation or final alive confirmation time over 1 hour.
• Densities of AR and PL were measured using PMCT images at the level of the left atrium's pulmonary vein entry.
• The PCAI was defined as the time between estimated cardiac arrest and PMCT acquisition.

Main Results:

• A significant negative correlation was observed between AR density and PCAI in 59 patients who died from cardiovascular disease (CVD).
• A regression equation (PCAI = -1.725 × AR + 132.95) was derived from this correlation.
• No significant correlation was found between PL density and PCAI.

Conclusions:

• The density of the anterior right atrium decreases as the post-cardiac arrest interval increases in cases of cardiovascular disease.
• The derived regression equation may serve as an additional tool for estimating the post-cardiac arrest interval in forensic evaluations.