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Lung densitometry in postmortem computed tomography - comparison across different fatal asphyxia groups.

Søren Reinhold Jakobsen1,2, Lars Schellerup3, Lene Warner Thorup Boel3

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Asphyxia deaths are hard to diagnose. Lung densitometry on postmortem CT scans shows lower lung density in asphyxia cases, aiding forensic diagnosis.

Keywords:
AsphyxiaEmphysemaHomicideLung densitometryPMCT

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Area of Science:

  • Forensic Medicine
  • Radiology
  • Pathology

Background:

  • Asphyxia presents diagnostic challenges in forensic medicine due to varied mechanisms and lack of specific markers.
  • Acute emphysema or alveolar dilation are debated findings in asphyxia cases.
  • Lung densitometry offers a quantitative approach to assess pulmonary changes.

Purpose of the Study:

  • To investigate lung densitometry parameters in postmortem computed tomography (PMCT) data of asphyxia cases.
  • To determine if lung densitometry can identify characteristic findings associated with asphyxia.

Main Methods:

  • Analysis of PMCT data from 20 asphyxia cases (hanging, strangulation, smothering, choking) and 21 matched controls.
  • Application of lung densitometry to quantify low attenuation areas (LAA) and the 15th percentile lung density (Perc15).

Main Results:

  • Asphyxia cases showed statistically significant higher lung % volume within LAA at -950HU and -910HU compared to controls.
  • Perc15 values trended towards lower attenuation (lower density) in asphyxia cases, though not statistically significant.
  • Choking subgroup exhibited higher Perc15 values.

Conclusions:

  • The study supports low pulmonary density as a potential finding in asphyxia.
  • Lung densitometry applied to PMCT data shows promise for aiding in the forensic diagnosis of asphyxia.