Utility of postmortem computed tomography in trauma victims

A possible way to circumvent the continuing decline in the number of autopsies is to perform computed tomography after death. The present study compares the pathologic findings of postmortem CT tomography (PMCT) in trauma fatalities with those disclosed upon conventional forensic autopsy. Within 6 hours of death, the bodies of 25 trauma victims underwent total body CT scanning, all with permission of the relatives, followed by conventional autopsy in 13 cases under court order. The pathologist and roentgenologist were unaware of each other's findings. The pathologic findings of PMCT plus conventional autopsy provided more information than either examination alone. Of the total 127 pathologic findings, 44.9% were diagnosed by both conventional autopsy and PMCT, 29.9% were not revealed by PMCT, whereas conventional autopsy missed 25.2%, and PMCT detected more bone injuries than did autopsy, whereas the latter was superior to PMCT in discovering soft-tissue pathologic states. In all, PMCT revealed 70.5% and autopsy 74.8% of the pathologic states. Although PMCT was not more effective than conventional autopsy in exposing pathologic entities, it increased the yield of findings when combined with conventional autopsy. Where conventional autopsy is unattainable, PMCT may be effective in shedding light on the pathologic state and mechanism of death in trauma fatalities.