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Comparison of volume and attenuation of the spleen between postmortem and antemortem computed tomography

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Abstract

Objectives

The purpose of this study is to compare the postmortem changes in computed tomography (CT) findings between normal spleen, splenic infarct, and splenic tumor infiltration.

Methods

The institutional review board approved this study, and informed consent was obtained from the next of kin. We studied 63 consecutive subjects who underwent antemortem CT, postmortem CT, and autopsy between February 2012 and December 2013. Postmortem CT was performed within 1678 min after death and was followed by pathological studies. The subjects were divided into three groups based on the pathological findings: normal, splenic infarct, and splenic tumor infiltration. The volume and attenuation of the spleen were compared between antemortem and postmortem CT using paired t tests. Gender, age, time elapsed since death, and the causes of death were examined as potential confounding factors of the postmortem changes in volume and attenuation.

Results

In all groups, the spleen decreased in volume and attenuation increased on postmortem CT compared with antemortem CT. The postmortem changes in spleen volume and attenuation were not significantly associated with sex, age, time elapsed since death, or causes of death.

Conclusions

Spleen volume decreased and attenuation increased on postmortem CT compared with antemortem CT in subjects with a normal spleen, splenic infarct, or splenic tumor infiltration. These results should caution us against underestimating the significance of splenomegaly on postmortem CT, misinterpreting reduced splenic volume as the presence of hypovolemic or distributive shock in the subject while alive, and confusing postmortem splenic hyperattenuation with diseases characterized by this finding.

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Acknowledgments

We thank the executives of our hospital for supporting the maintenance of the CT scanners, the clinical doctors in the relevant hospital departments for obtaining informed consent from each subject’s next of kin and for mediating between the subjects and our study group, and Dr. Yutaka Takazawa for helping us with the postmortem CT scanning. This work was supported by a grant from the Japanese Ministry of Health, Labor and Welfare, for research into “Usefulness of Postmortem Images as an Ancillary Method for Autopsy in Evaluation of Death Associated with Medical Practice (2008–2009).”

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hidemi Okuma, Wataru Gonoi, Go Shirota, Shigeaki Kanno & Kuni Ohtomo

  2. Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, 2-5 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8326, Japan

    Masanori Ishida

  3. Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Yukako Shintani, Hiroyuki Abe & Masashi Fukayama

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  1. Hidemi Okuma
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  2. Wataru Gonoi
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  5. Shigeaki Kanno
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  9. Kuni Ohtomo
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Correspondence to Wataru Gonoi.

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Okuma, H., Gonoi, W., Ishida, M. et al. Comparison of volume and attenuation of the spleen between postmortem and antemortem computed tomography. Int J Legal Med 130, 1081–1087 (2016). https://doi.org/10.1007/s00414-016-1337-0

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  • DOI: https://doi.org/10.1007/s00414-016-1337-0

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