From the Department of Pathology.
Department of Radiology, State University of New York-Upstate Medical University, Syracuse, NY.
Am J Forensic Med Pathol. 2020 Sep;41(3):163-175. doi: 10.1097/PAF.0000000000000538.
The use of postmortem computed tomography (PMCT) to support autopsy pathology has increased in recent decades. To some extent, PMCT has also been contemplated as a potential alternative to conventional postmortem examination. The purpose of this study was to investigate the ability of PMCT to detect specific pathologic findings in the head and brain in natural hospital deaths.We examined postmortem CT images and autopsy data from 31 subjects who died at SUNY (State University of New York) Upstate University Hospital between 2013 and 2018. Each subject underwent a noncontrast PMCT and a traditional autopsy. A neuroradiologist analyzed PMCT images for head and brain abnormalities. The autopsies were performed by pathologists who were aware of the radiology results.In our series, PMCT was able to detect the majority of the significant space-occupying lesions, although it was not always reliable in ascertaining their nature. Postmortem computed tomography revealed findings usually challenging to detect at autopsy. Unfortunately, there were also situations in which PMCT was misleading, showing changes that were difficult to interpret, or that could be related to postmortem events. Therefore, we conclude PMCT should be used as an adjunct rather than a substitute to autopsy.
近年来，死后计算机断层扫描（PMCT）在支持尸检病理学方面的应用有所增加。在某种程度上，PMCT 也被视为常规尸检的潜在替代方法。本研究旨在探讨 PMCT 检测自然死亡患者头部和脑部特定病理发现的能力。
我们检查了 2013 年至 2018 年间在纽约州立大学上州医科大学医院死亡的 31 名患者的死后 CT 图像和尸检数据。每位患者均接受了非对比 PMCT 和传统尸检。神经放射科医生分析了头部和脑部异常的 PMCT 图像。尸检由了解放射学结果的病理学家进行。
在我们的系列中，PMCT 能够检测到大多数显著的占位性病变，尽管它并不总是能够可靠地确定其性质。PMCT 揭示了通常在尸检中难以检测到的发现。不幸的是，也有一些 PMCT 产生误导的情况，显示出难以解释的变化，或者可能与死后事件有关。因此，我们得出结论，PMCT 应作为辅助手段而不是尸检的替代品使用。
