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Quantification of interstitial fluid on whole body CT: comparison with whole body autopsy

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Abstract

Purpose

Interstitial fluid accumulation can occur in pleural, pericardial, and peritoneal spaces, and subcutaneous tissue planes. The purpose of the study was to assess if whole body CT examination in a postmortem setting could help determine the presence and severity of third space fluid accumulation in the body.

Materials and methods

Our study included 41 human cadavers (mean age 61 years, 25 males and 16 females) who had whole-body postmortem CT prior to autopsy. All bodies were maintained in the morgue in the time interval between death and autopsy. Two radiologists reviewed the whole-body CT examinations independently to grade third space fluid in the pleura, pericardium, peritoneum, and subcutaneous space using a 5-point grading system. Qualitative CT grading for third space fluid was correlated with the amount of fluid found on autopsy and the quantitative CT fluid volume, estimated using a dedicated software program (Volume, Syngo Explorer, Siemens Healthcare).

Results

Moderate and severe peripheral edema was seen in 16/41 and 7/41 cadavers respectively. It is not possible to quantify anasarca at autopsy. Correlation between imaging data for third space fluid and the quantity of fluid found during autopsy was 0.83 for pleural effusion, 0.4 for pericardial effusion and 0.9 for ascites. The degree of anasarca was significantly correlated with the severity of ascites (p < 0.0001) but not with pleural or pericardial effusion. There was strong correlation between volumetric estimation and qualitative grading for anasarca (p < 0.0001) and pleural effusion (p < 0.0001).

Conclusion

Postmortem CT can help in accurate detection and quantification of third space fluid accumulation. The quantity of ascitic fluid on postmortem CT can predict the extent of anasarca.

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

    Roberto Lo Gullo, Shelly Mishra, Diego A. Lira, Atul Padole, Alexi Otrakji, Ranish Deedar Ali Khawaja, Sarvenaz Pourjabbar, Sarabjeet Singh, Jo-Anne O. Shepard, Subba R. Digumarthy & Mannudeep K. Kalra

  2. Department of Radiology, School of Medicine, University of Milano, Milan, Italy

    Roberto Lo Gullo

  3. Department of Pathology and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

    James R. Stone

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  1. Roberto Lo Gullo
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  2. Shelly Mishra
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  3. Diego A. Lira
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  4. Atul Padole
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  9. Jo-Anne O. Shepard
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  11. Mannudeep K. Kalra
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  12. James R. Stone
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Correspondence to Roberto Lo Gullo.

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Lo Gullo, R., Mishra, S., Lira, D.A. et al. Quantification of interstitial fluid on whole body CT: comparison with whole body autopsy. Forensic Sci Med Pathol 11, 488–496 (2015). https://doi.org/10.1007/s12024-015-9728-y

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  • DOI: https://doi.org/10.1007/s12024-015-9728-y

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