Effects of postmortem interval on postmortem computed tomography findings in bath-related drowning cases

Area of Science:

• Forensic pathology
• Radiology
• Medical imaging

Background:

• Postmortem interval (PMI) estimation is crucial in forensic investigations.
• The reliability of postmortem computed tomography (PMCT) findings for PMI determination in drowning cases requires further clarification.

Purpose of the Study:

• To identify postmortem computed tomography (PMCT) findings that are susceptible to changes with postmortem interval (PMI).
• To identify postmortem computed tomography (PMCT) findings that remain relatively stable across different postmortem intervals (PMI) in bath-related drowning cases.

Main Methods:

• Analysis of 72 bath-related drowning cases, excluding those with pre-PMCT resuscitation.
• Quantitative PMCT findings assessed using Spearman's rank correlation and Mann-Whitney U test.
• Multivariable regression analyses performed, adjusting for age and sex.

Main Results:

• Sphenoid sinus-fluid volume, gastric-fluid volume, and ethmoid sinus-fluid accumulation showed no significant PMI association after adjustment.
• Pleural effusion volume, anterior mediastinal distance, right diaphragm level, splenic attenuation, total stomach volume, and gastric-air volume were significantly associated with PMI.
• Maxillary sinus-fluid volume association with PMI lost significance after adjustment.

Conclusions:

• Sphenoid sinus-fluid volume, ethmoid sinus-fluid accumulation, and gastric-fluid volume are relatively stable PMCT findings across varying PMIs in drowning.
• These stable findings may aid in postmortem interval estimation in bath-related drowning cases.
• Other PMCT findings are susceptible to PMI changes and require careful interpretation.