Forensic postmortem computed tomography: volumetric measurement of the heart and liver
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TECHNICAL REPORT
Forensic postmortem computed tomography: volumetric measurement of the heart and liver Lykke Schrøder Jakobsen1 • Sissel Lundemose1 • Jytte Banner1 • Niels Lynnerup1 Christina Jacobsen1
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Accepted: 26 August 2016 Ó Springer Science+Business Media New York 2016
Abstract Purpose The purpose of this study was to investigate the utility of postmortem computed tomography (PMCT) images in estimating organ sizes and to examine the use of the cardiothoracic ratio (CTR). Methods We included 45 individuals (19 females), who underwent a medico-legal autopsy. Using the computer software program MimicsÒ, we determined in situ heart and liver volumes derived from linear measurements (width, height and depth) on a whole body PMCT-scan, and compared the volumes with ex vivo volumes derived by CT-scan of the eviscerated heart and liver. The ex vivo volumes were also compared with the organ weights. Further, we compared the CTR with the ex vivo heart volume and a heart weight-ratio (HWR). Intra- and interobserver analyses were performed.
Results We found no correlation between the in situ and ex vivo volumes of the heart and liver. However, a highly significant correlation was found between the ex vivo volumes and weights of the heart and liver. No correlations between CTR and the ex vivo heart volume nor with HWR was found. Concerning cardiomegaly, we found no agreement between the CTR and HWR. The intra- and inter-observer analyses showed no significant differences. Conclusions Noninvasive in situ PMCT methods for organ measuring, as performed in this study, are not useful tools in forensic pathology. The best method to estimate organ volume is a CT-scan of the eviscerated organ. PMCT-determined CTR seems to be useless for ascertaining cardiomegaly, as it neither correlated with the ex vivo heart volume nor with the HWR. Keywords Postmortem computed tomography Organ size Volumetric determination CTR Morphometry
Electronic supplementary material The online version of this article (doi:10.1007/s12024-016-9810-0) contains supplementary material, which is available to authorized users. & Lykke Schrøder Jakobsen [email protected] Sissel Lundemose [email protected] Jytte Banner [email protected] Niels Lynnerup [email protected] Christina Jacobsen [email protected] 1
Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Frederik V’s vej 11, 2100 Copenhagen East, Denmark
Introduction Organ sizes and weights support organ-specific diagnoses [1–3]. Since the implementation of postmortem computed tomography (PMCT) in forensic practice [4–10] several studies have investigated the utility of imaging in estimating organ sizes [11–13] (Online Resource 1). At our department, PMCT has been performed prior to every autopsy since 2002 [7]. The aim of this study was to investigate the utility of PMCT images in estimating organ sizes and to examine the use of the cardiothoracic ratio (CTR). Therefore we compared (1) PMCT-derived in situ volumes with C
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