Skip to main content

Advertisement

SpringerLink
Log in

Diagnosis of pulmonary infarction in post-mortem computed tomography and post-mortem magnetic resonance imaging—a technical note

  • Method Paper
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

Pulmonary thromboembolism may be accompanied by pulmonary infarction. Even though pulmonary thromboembolism (PTE) is a frequently found cause of death at autopsy, pulmonary infarction accompanying PTE is a less common finding and may therefore easily be misinterpreted as infectious or cancerous lung disease. Appearance of pulmonary infarction in post-mortem imaging and acquisition parameters helping to identify pulmonary infarctions are not described yet. Based on a case of a 50-year-old man who died due to PTE and presented pulmonary infarction, we suggest using a pulmonary algorithm in post-mortem computed tomography combined with post-mortem magnetic resonance imaging of the lungs using conventional T1- and T2-weighted sequences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jackowski C, Grabherr S, Schwendener N (2013) Pulmonary thrombembolism as cause of death on unenhanced postmortem 3T MRI. Eur Radiol 23:1266–1270. https://doi.org/10.1007/s00330-012-2728-3

    Article  PubMed  Google Scholar 

  2. (2000) Recommendation no. R (99) 3 of the Committee of Ministers to member states on the harmonization of medico-legal autopsy rules. Forensic Sci Int 111:5–58

  3. Willaume T, Farrugia A, Kieffer E-M, Charton J, Geraut A, Berthelon L, Bierry G, Raul JS (2018) The benefits and pitfalls of post-mortem computed tomography in forensic external examination: a retrospective study of 145 cases. Forensic Sci Int 286:70–80. https://doi.org/10.1016/j.forsciint.2018.02.030

    Article  PubMed  Google Scholar 

  4. Mishima S, Suzuki H, Fukunaga T, Nishitani Y (2018) Postmortem computed tomography findings in cases of bath-related death: applicability and limitation in forensic practice. Forensic Sci Int 282:195–203. https://doi.org/10.1016/j.forsciint.2017.11.030

    Article  PubMed  Google Scholar 

  5. Schwendener N, Jackowski C, Persson A, Warntjes MJ, Schuster F, Riva F, Zech WD (2017) Detection and differentiation of early acute and following age stages of myocardial infarction with quantitative post-mortem cardiac 1.5T MR. Forensic Sci Int 270:248–254. https://doi.org/10.1016/j.forsciint.2016.10.014

    Article  PubMed  Google Scholar 

  6. Mokrane F-Z, Savall F, Dercle L, Crubezy E, Telmon N, Rousseau H, Dedouit F (2017) Technical note: a preliminary comparative study between classical and interventional radiological approaches for multi-phase post-mortem CT angiography. Forensic Sci Int 271:23–32. https://doi.org/10.1016/j.forsciint.2016.12.008

    Article  PubMed  Google Scholar 

  7. Micallef MJ (2018) The autopsy and diagnosis of pulmonary thrombo-embolism. Forensic Sci Med Pathol 14:241–243. https://doi.org/10.1007/s12024-018-9950-5

    Article  PubMed  Google Scholar 

  8. Rutty GN, Morgan B, Robinson C et al (2017) Diagnostic accuracy of post-mortem CT with targeted coronary angiography versus autopsy for coroner-requested post-mortem investigations: a prospective, masked, comparison study. Lancet Lond Engl 390:145–154. https://doi.org/10.1016/S0140-6736(17)30333-1

    Article  Google Scholar 

  9. Harty MP, Harcke HT, Gould SW, Sukula-Perlman A (2018) Pulmonary embolus as cause of death in an adolescent: demonstration on postmortem CT. Pediatr Radiol 48:745–748. https://doi.org/10.1007/s00247-017-4041-4

    Article  PubMed  Google Scholar 

  10. von Both I, Bruni SG, Herath JC (2018) Differentiation of antemortem pulmonary thromboembolism and postmortem clot with unenhanced MRI: a case report. Forensic Sci Med Pathol 14:95–101. https://doi.org/10.1007/s12024-017-9940-z

    Article  Google Scholar 

  11. Ampanozi G, Held U, Ruder TD et al (2016) Pulmonary thromboembolism on unenhanced postmortem computed tomography: feasibility and findings. Leg Med Tokyo Jpn 20:68–74. https://doi.org/10.1016/j.legalmed.2016.04.005

    Article  Google Scholar 

  12. Burke MP, Bedford P, Baber Y (2014) Can forensic pathologists diagnose pulmonary thromboembolism on postmortem computed tomography pulmonary angiography? Am J Forensic Med Pathol 35:124–131. https://doi.org/10.1097/PAF.0000000000000086

    Article  PubMed  Google Scholar 

  13. Gaeta M, Ascenti G, Mazziotti S et al (2012) MRI differentiation of pneumonia-like mucinous adenocarcinoma and infectious pneumonia. Eur J Radiol 81:3587–3591. https://doi.org/10.1016/j.ejrad.2011.12.022

    Article  PubMed  Google Scholar 

  14. He H, Stein MW, Zalta B, Haramati LB (2006) Pulmonary infarction: spectrum of findings on multidetector helical CT. J Thorac Imaging 21:1–7. https://doi.org/10.1097/01.rti.0000187433.06762.fb

    Article  CAS  PubMed  Google Scholar 

  15. Hampton AO (1940) Correlation of postmortem chest teleroentogenograms with autopsy findings, with special reference to pulmonary embolism and infarction. Am J Roentgenol 43:305–326

    Google Scholar 

  16. Miniati M (2016) Pulmonary infarction: an often unrecognized clinical entity. Semin Thromb Hemost 42:865–869. https://doi.org/10.1055/s-0036-1592310

    Article  PubMed  Google Scholar 

  17. Rosado-de-Christenson ML, Abbott GF, McAdams HP, Franks TJ, Galvin JR (2003) From the archives of the AFIP. RadioGraphics 23:759–783. https://doi.org/10.1148/rg.233025165

    Article  PubMed  Google Scholar 

  18. Luciano C, Francesco A, Giovanni V et al (2011) CT signs, patterns and differential diagnosis of solitary fibrous tumors of the pleura. J Thorac Dis 2:21-25–21-25

    Google Scholar 

  19. Pictorial essay of radiological features of benign intrathoracic masses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4652288/. Accessed 22 Nov 2019

  20. Ikeda G, Yamamoto R, Suzuki M, Ishikawa H, Kikuchi K, Shiotani S (2007) Postmortem computed tomography and magnetic resonance imaging in a case of terminal-stage small cell lung cancer: an experience of autopsy imaging in tumor-related death. Radiat Med 25:84–87. https://doi.org/10.1007/s11604-006-0104-4

    Article  PubMed  Google Scholar 

  21. Jackowski C, Thali M, Aghayev E, Yen K, Sonnenschein M, Zwygart K, Dirnhofer R, Vock P (2006) Postmortem imaging of blood and its characteristics using MSCT and MRI. Int J Legal Med 120:233–240. https://doi.org/10.1007/s00414-005-0023-4

    Article  CAS  PubMed  Google Scholar 

  22. Pulmonary arterial bands and webs; an unrecognized manifestation of organized pulmonary emboli. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949576/. Accessed 14 Nov 2019

  23. Castañer E, Gallardo X, Ballesteros E et al (2009) CT diagnosis of chronic pulmonary thromboembolism. RadioGraphics 29:31–50. https://doi.org/10.1148/rg.291085061

    Article  PubMed  Google Scholar 

  24. Chronic pulmonary embolism: diagnosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039808/. Accessed 14 Nov 2019

  25. Bray TJP, Mortensen KH, Gopalan D (2014) Multimodality imaging of pulmonary infarction. Eur J Radiol 83:2240–2254. https://doi.org/10.1016/j.ejrad.2014.07.016

    Article  CAS  PubMed  Google Scholar 

  26. Ruder TD, Hatch GM, Siegenthaler L, Ampanozi G, Mathier S, Thali MJ, Weber OM (2012) The influence of body temperature on image contrast in post mortem MRI. Eur J Radiol 81:1366–1370. https://doi.org/10.1016/j.ejrad.2011.02.062

    Article  PubMed  Google Scholar 

  27. Ruder TD, Thali MJ, Hatch GM (2014) Essentials of forensic post-mortem MR imaging in adults. Br J Radiol 87. https://doi.org/10.1259/bjr.20130567

  28. Wagensveld IM, Blokker BM, Wielopolski PA et al (2017) Total-body CT and MR features of postmortem change in in-hospital deaths. PLoS One 12. https://doi.org/10.1371/journal.pone.0185115

  29. Dixon WT (1984) Simple proton spectroscopic imaging. Radiology 153:189–194. https://doi.org/10.1148/radiology.153.1.6089263

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Forensic Medicine, University of Bern, Bühlstrasse 20, 3012, Bern, Switzerland

    Nicolas Herr, Paolo Lombardo, Christian Jackowski & Wolf Dieter Zech

  2. Department of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital, Freiburgstrasse 10, 3010, Bern, Switzerland

    Paolo Lombardo

Authors
  1. Nicolas Herr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paolo Lombardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Jackowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wolf Dieter Zech
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wolf Dieter Zech.

Ethics declarations

This article does not contain any studies with live human participants or animals.

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Herr, N., Lombardo, P., Jackowski, C. et al. Diagnosis of pulmonary infarction in post-mortem computed tomography and post-mortem magnetic resonance imaging—a technical note. Int J Legal Med 134, 1817–1821 (2020). https://doi.org/10.1007/s00414-020-02273-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-020-02273-5

Keywords

Search

Navigation