Department of Pediatrics, Kansai Medical University, 2-5-1 Shin-machi, Hirakata-shi, Osaka 573 1010, Japan.
Biomed Res Int. 2013;2013:327903. doi: 10.1155/2013/327903. Epub 2013 Sep 4.
To determine the accuracy of postmortem computed tomography (PMCT) for the assessment of causes in nontraumatic deaths in children.
We enrolled cases of nontraumatic deaths of infants and children who underwent PMCT at a single center. The presumed cause of death determined by PMCT was prospectively compared with the clinical and pathological diagnoses of deaths.
Thirty-eight cases were enrolled for analysis. Among them, seven cases also underwent conventional medical autopsy. PMCT revealed an identifiable cause of death in accordance with the clinical diagnosis of death in 16 cases of the 38 cases (the concordance rate was 42%) and in accordance with the autopsy cause of death in four of the seven autopsy cases (the concordance rate was 57%). Among eight cases with unknown cause of death by clinical diagnosis, four cases (50%) were identified with cardiac tamponade as a cause of death (one case) and intracranial hemorrhage suggesting abuse (3 cases).
PMCT seems to be a promising technique that might serve as a substitute for conventional medical autopsy and give us the complementary information to clinical diagnoses particularly in cases of child abuse. Larger multicenter trials are worthwhile to validate the general feasibility of PMCT.
确定死后计算机断层扫描（PMCT）在评估儿童非创伤性死亡原因方面的准确性。
我们纳入了在一家中心接受 PMCT 的非创伤性婴儿和儿童死亡病例。前瞻性地将 PMCT 确定的死亡原因与临床和病理死亡诊断进行比较。
共纳入 38 例进行分析。其中，7 例还进行了常规医学尸检。PMCT 在 38 例中的 16 例中与临床死亡诊断相符（符合率为 42%），在 7 例尸检病例中的 4 例中与尸检死亡原因相符（符合率为 57%）。在 8 例临床死因不明的病例中，4 例（50%）被确定为心脏压塞（1 例）和提示虐待的颅内出血（3 例）。
PMCT 似乎是一种很有前途的技术，可替代常规医学尸检，并为临床诊断提供补充信息，尤其是在儿童虐待的情况下。值得开展更大规模的多中心试验来验证 PMCT 的一般可行性。
