Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Department of Clinical Imaging, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
Eur Radiol. 2021 Dec;31(12):8879-8886. doi: 10.1007/s00330-021-08052-z. Epub 2021 Jun 8.
To classify the types of hyperdense areas in the heart cavities on post-mortem CT (PMCT) and compare them according to the presence of blood clots in the heart cavities at forensic autopsy.
One hundred and twelve cases with CT images taken before forensic autopsy were evaluated. The presence and shape of hyperdense areas in the right or left heart cavities were retrospectively evaluated on PMCT images and were classified into four types (block-like, cast-like, fluid level-like, and unclear). The presence of blood clots was confirmed when there were clots in the heart cavities at forensic autopsy.
Of the 112 cases, 57 exhibited blood clots in the heart cavities at forensic autopsy. The hyperdense areas in the right heart cavities on PMCT in 57 cases exhibiting blood clots at forensic autopsy were classified as follows: block-like, 32; fluid level-like, 4; cast-like, 17; and unclear, 4. The sensitivity of block-like and cast-like hyperdense areas in the right heart cavities on PMCT for the presence of clots in the heart cavities at forensic autopsy was 86% (95% confidence interval [CI]: 74-94%); the corresponding specificity, PPV, and NPV were 95% (95% CI: 85-99%), 94% (95% CI: 84-99%), and 87% (95% CI: 75-94%), respectively.
Block-like and cast-like hyperdense areas in the right heart cavities on PMCT predicted the presence of intracardiac blood clots at forensic autopsy.
• Clinical radiologists likely have no experience of interpreting findings of blood clots on post-mortem CT (PMCT). • The appearance of blood clots on PMCT provides important clues for diagnosing the cause and process of death. • The shapes of the hyperdense areas in the heart cavities were classified into four types, and two of these types could be used to predict the presence of blood clots in the heart cavities at forensic autopsy.
对死后 CT（PMCT）上心腔中高密度区的类型进行分类，并根据法医尸检中心腔中是否存在血栓进行比较。
对 112 例生前进行 CT 检查且死后行 PMCT 检查的病例进行评估。回顾性评估 PMCT 图像上心腔中高密度区的存在和形状，并将其分为 4 种类型（块状、铸型样、液平样和不清楚）。当法医尸检中心腔中有血栓时，可确定存在血栓。
112 例患者中，57 例在法医尸检中心腔中发现有血栓。57 例死后 PMCT 检查显示右心腔中有血栓的患者中，右心腔高密度区如下分类：块状，32 例；液平样，4 例；铸型样，17 例；不清楚，4 例。PMCT 检查右心腔中块状和铸型样高密度区对法医尸检中心腔中血栓的存在具有 86%（95%置信区间[CI]：74-94%）的灵敏度；相应的特异度、PPV 和 NPV 分别为 95%（95% CI：85-99%）、94%（95% CI：84-99%）和 87%（95% CI：75-94%）。
PMCT 检查右心腔中块状和铸型样高密度区可预测法医尸检中心腔中存在血栓。
临床放射科医生可能没有解读死后 CT（PMCT）上血栓表现的经验。
PMCT 上血栓的表现为诊断死亡原因和过程提供了重要线索。
心腔中高密度区的形状分为 4 种类型，其中 2 种类型可用于预测法医尸检中心腔中血栓的存在。
Zotero 插件