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Post-mortem computed tomography (PMCT) radiological findings and assessment in advanced decomposed bodies

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Abstract

Purpose

The aim of the study is to report radiological findings and features in advanced decomposed bodies obtained by post-mortem computed tomography (PMCT) with autopsy correlation.

Materials and methods

This retrospective descriptive multicentric study included 41 forensic cases examined between May 2013 and November 2016. All the bodies were PMCT-scanned prior to autopsy, and internal putrefactive state was determined using the radiological alteration index (RAI) by a radiologist with expertise in forensic radiology and a forensic pathologist trained in forensic imaging. After PMCT scans, grade of external putrefaction (GEP) was assigned during the external examination and the complete autopsy was performed by forensic pathologists.

Results

The PMCT images evaluation revealed that the RAI index was > 61 in all bodies, corresponding to a moderate-massive presence of putrefactive gas. The gas grade was > II in correspondence of the major vessels, heart cavities, liver parenchyma, vertebra L3 and subcutaneous pectoral tissues, and varied from I to III in correspondence of the kidney. Cadaveric external examination revealed the presence of advanced transformative phenomena, with a GEP3 and GEP4 in most of the cases, with body swelling, eyes and tongue protrusion, body fluids expulsion and fat liquefaction.

Conclusion

Radiological imaging by PMCT as an adjunct to autopsy in advanced decomposed bodies represents a useful tool in detecting post-mortem gas, even in very small amounts. A correct interpretation process of the PMCT data is essential to avoid images pitfalls, due to natural decomposition that can be mistaken for pathologic processes.

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Authors and Affiliations

  1. Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, RM, Italy

    Gaia Cartocci, Alessandro Santurro, Raffaele La Russa, Paola Frati & Vittorio Fineschi

  2. Department of Morphology, Experimental Medicine and Surgery, University of Ferrara, Via Fossato di Mortara 70, 44121, Ferrara, FE, Italy

    Margherita Neri

  3. Department of Radiology, School of Clinical Medicine, University of Cambridge, Hills Rd, Cambridge, CB2 0SP, UK

    Fulvio Zaccagna

  4. Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, RM, Italy

    Carlo Catalano & Valeria Panebianco

  5. IRCSS Neuromed Mediterranean Neurological Institute, Via Atinense 18, 86077, Pozzilli, IS, Italy

    Raffaele La Russa, Paola Frati & Vittorio Fineschi

  6. Department of Surgical Pathology, Medical, Molecular and Critical Area, Institute of Legal Medicine, University of Pisa, Via Roma 55, 56126, Pisa, PI, Italy

    Emanuela Turillazzi

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  1. Gaia Cartocci
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Correspondence to Vittorio Fineschi.

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The processing of the data reported in this paper is covered by the general authorization to process personal data for scientific research purposes granted by the Italian Data Protection Authority (1 March 2012 as published in Italy’s Official Journal No. 72 dated 26 March 2012) since the data do not entail any significant personalized impact on data subjects. Our study does not involve the application of experimental protocols; therefore, it does not require approval by an institutional and/or licensing committee. In all cases, local prosecutors opened an investigation, ordering that an autopsy be performed to clarify the exact cause of death.

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Cartocci, G., Santurro, A., Neri, M. et al. Post-mortem computed tomography (PMCT) radiological findings and assessment in advanced decomposed bodies. Radiol med 124, 1018–1027 (2019). https://doi.org/10.1007/s11547-019-01052-6

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