Postmortem Computed Tomography Research Articles

Performance of postmortem CT in the diagnosis of natural death from out-of-hospital cardiac arrest.

Postmortem CT (PMCT) is used widely to identify the cause of death. However, its diagnostic performance in cases of natural death from out-of-hospital cardiac arrest (OHCA) may be unsatisfactory because the cause tends to be cardiogenic and cannot be detected on PMCT images. We retrospectively investigated the diagnostic performance of PMCT in the diagnosis of natural death from OHCA and compared it to that of unnatural death. Our series included 450 cases; 336 were natural- and 114 were unnatural death cases. Between 2018 and 2022 all underwent non-contrast PMCT to identify the cause of death. Two radiologists reviewed the PMCT images and categorized them as diagnostic (PMCT alone sufficient to determine the cause of death), suggestive (the cause of death was suggested but additional information was needed), and non-diagnostic (the cause of death could not be determined on PMCT images). The diagnostic performance of PMCT was defined by the percentage of diagnosable and suggestive cases and compared between natural- and unnatural death cases. Interobserver agreement for the cause of death on PMCT images was also assessed with the Cohen kappa coefficient of concordance. The diagnostic performance of PMCT for the cause of natural- and unnatural deaths from OHCA was 30.3% and 66.6%, respectively (p < 0.01). The interobserver agreement for the cause of natural- and unnatural deaths on PMCT images was very good with kappa value 0.92 and 0.96, respectively. As PMCT identified the cause of natural death by OHCA in only 30% of cases, its diagnostic performance must be improved.

Effectiveness of low dose computed tomography to detect fractures in paediatric suspected physical abuse: a systematic review.

The skeletal survey X-ray series is the current 'gold standard' when investigating suspected physical abuse (SPA) of children, in addition to a non-contrast computed tomography (CT) brain scan. This systematic literature review synthesised findings of published research to determine if low dose computed tomography (LDCT) could detect subtle fractures and therefore replace the skeletal survey X-ray series in the investigation of SPA in children aged under 3 years. Five electronic databases and grey literature were systematically searched from their inception to 28 April 2022. Primary studies were included where the population comprised paediatric patients up to 16 years and LDCT was used to detect fractures associated with SPA. Studies involving imaging investigations of the head, standard dose CT examinations or accidental trauma were excluded. Three studies met the inclusion criteria, all of which were case series. These studies did not report many of the criteria required to compare the accuracy of LDCT to X-ray, i.e. they did not meet the criteria for a diagnostic accuracy test. Therefore, it is difficult to conclude from the case series if LDCT is accurate enough to replace X-rays. Due to the gap in current literature, a phantom study and subsequent post-mortem CT study are recommended as the primary investigative methods to assess the ability of low-dose CT to identify the subtle fractures associated with SPA and to calculate how low the achievable CT dose can be.

Oxygenation and ventilation during prolonged experimental cardiopulmonary resuscitation with either continuous or 30:2 compression-to-ventilation ratios together with 10 cmH20 positive end-expiratory pressure

BackgroundIn refractory out-of-hospital cardiac arrest, the patient is commonly transported to hospital with mechanical continuous chest compressions (CCC). Limited data are available on the optimal ventilation strategy. Accordingly, we compared arterial oxygenation and haemodynamics during manual asynchronous continuous ventilation and compressions with a 30:2 compression-to-ventilation ratio together with the use of 10 cmH2O positive end-expiratory pressure (PEEP).MethodsIntubated and anaesthetized landrace pigs with electrically induced ventricular fibrillation were left untreated for 5 min (n = 31, weight ca. 55 kg), after which they were randomized to either the CCC group or the 30:2 group with the the LUCAS® 2 piston device and bag-valve ventilation with 100% oxygen targeting a tidal volume of 8 ml/kg with a PEEP of 10 cmH2O for 35 min. Arterial blood samples were analysed every 5 min, vital signs, near-infrared spectroscopy and electrical impedance tomography (EIT) were measured continuously, and post-mortem CT scans of the lungs were obtained.ResultsThe arterial blood values (median + interquartile range) at the 30-min time point were as follows: PaO2: 180 (86–302) mmHg for the 30:2 group; 70 (49–358) mmHg for the CCC group; PaCO2: 41 (29–53) mmHg for the 30:2 group; 44 (21–67) mmHg for the CCC group; and lactate: 12.8 (10.4–15.5) mmol/l for the 30:2 group; 14.7 (11.8–16.1) mmol/l for the CCC group. The differences were not statistically significant. In linear mixed models, there were no significant differences between the groups. The mean arterial pressures from the femoral artery, end-tidal CO2, distributions of ventilation from EIT and mean aeration of lung tissue in post-mortem CTs were similar between the groups. Eight pneumothoraces occurred in the CCC group and 2 in the 30:2 group, a statistically significant difference (p = 0.04).ConclusionsThe 30:2 and CCC protocols with a PEEP of 10 cmH2O resulted in similar gas exchange and vital sign outcomes in an experimental model of prolonged cardiac arrest with mechanical compressions, but the CCC protocol resulted in more post-mortem pneumothoraces.

High-risk coronary plaque of sudden cardiac death victims: postmortem CT angiographic features and histopathologic findings.

High-risk coronary plaques (HRP) are characterized in clinical radiological imaging by the presence of low plaque attenuation, a napkin-ring sign (NRS), spotty calcifications (SC) and a positive remodeling index (RI). To evaluate if these signs are detectable in postmortem imaging by a multi-phase postmortem CT angiography (MPMCTA), a retrospective study of a series of autopsy well-documented coronary plaques related to sudden cardiac death (SCD) was performed. Then correlations between histological and radiological findings were described. Fourty SCD cases due to acute coronary syndrome based on clinical history and confirmed at autopsy were selected (28 men and 12 women, age 53.3 ± 10.9). The culprit lesion was mainly situated in the proximal segments of coronary arteries, in the right coronary artery in 23 cases (57.5%), the left anterior descending artery in 13 cases (32.5%), the circumflex artery in 3 cases (7.5%) and in one case in the left main stem. MPMCTA showed a positive RI (≥ 1.1) in 75% of cases with a mean RI 1.39 ± 0.71. RI values were lower in cases with fibrotic plaques. NRS was observed in 40% of cases, low attenuation plaque in 46.3%, and SC in 48.7% of cases. There were significant correlations of the radiological presence of NRS for fibrolipid composition of the plaque (p-value 0.007), severe intraplaque inflammation (p-value 0.017), severe adventitial inflammation (p-value 0.021) and an increased vasa vasorum (p-value 0.012). A significant correlation (p-value 0.002) was observed between the presence of SC at radiological examination and the presence of punctuate/fragmented calcification at histology. In addition, in 58.3% of cases, plaque enhancement was observed, which correlated with plaque inflammation and the fibrolipid composition of the plaque. The coronary artery calcium score was 314 (± 455). There was a poor agreement between stenosis of the lumen at histology versus radiology. Our study shows that the various radiological signs of HRP can be detected in all plaques by MPMCTA, but individually only to a variable extent; plaque enhancement appeared as a new sign of vulnerability. In the postmortem approach, these radiological markers of HRP, should always be applied in combination, which can be useful for developing a predictive model for diagnosing coronary SCD.

Forensic significance and inferential value of PMCT features in charred bodies: A bicentric study

Post-mortem computed tomography (PMCT) is a diagnostic tool that provides essential information in forensic field. This radiological technique can play a pivotal role in personal identification, gunshot injuries, major traumatic injuries, child abuse, drowning asphyxia, embolism, COVID-19, sudden death, and charring cases.Post-mortem imaging can be used to investigate charred bodies as it allows the forensic examiner to distinguish traumatic and heat injuries. PMCT images can also provide additional information to determine whether the individual was alive at the time the fire started.In our bicentric study, we performed PMCT on 15 cases of charred bodies (10 males and 5 females) collected at the Florence University (Florence, Italy) and Catholic University of The Sacred Heart (Rome, Italy) before the external examination and/or full autopsy examination. In both the institutions, PMCT was performed through a Siemens SOMATOM 16-slice CT scanner (Siemens Aktiengesellschaft, Berlin, 2010).The aim of the current study was to obtain unambiguous information that could help determine the cause of death by comparing our PMCT findings with the most recent evidence in the scientific literature. Our investigations focused on the evaluation of bone texture and differences from traumatic fractures, leading also to an improvement in the interpretation of some aspecific findings (e.g., soot) from the integration of the radiological information with the autopsy results.The data obtained in our study support PMCT as a reliable diagnostic tool in the study of charred corpses and represent basic evidence for further applications of radiology in the forensic field.

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography.

Computed tomography angiography (PMCTA) is increasingly used in postmortem cases. Standardized validated protocols permit to compare different PMCTA images and make it more easily to defend a case in court. In addition to the well-known technique by Grabherr et al. (2011) which is using paraffin oil as a carrier substance, water-soluble polyethylene glycol 200 (PEG200) can be used in combination with the contrast agent Accupaque® 300. As to date, there exists no standardized protocol for the use of this contrast agent mixture, the aim of this study was to develop a protocol using it. Between 2012 and 2022, 23 PMCTA with PEG200 and Accupaque®300 were performed at the University Centre of Legal Medicine Lausanne (Switzerland) and the Institute of Forensic Medicine Munich (Germany). The images obtained were evaluated regarding the opacification of the vessels and possible artefacts. The best image quality was obtained with a mixing ratio of 1:15 (Accupaque®300:PEG200) and a perfusion volume of 1000ml in the arterial, 1400ml in the venous and 350ml in the dynamic phase. The infusion rates described by Grabherr et al. were confirmed for the three phases. Overall, the opacification of the vessels was diagnostically sufficient. In 13 cases no opacification of the right coronary artery was observed due to a stratification artefact. By using the PMCTA protocol with PEG200 as a carrier, a good overall image quality can be achieved. This protocol offers the possibility to standardize PMCTA with PEG200.

CT ANALYSIS OF SKULL CONTENTS IN NATURALLY MUMMIFIED HUMAN CORPSES, A MULTICENTRIC STUDY.

This study aimed to assess skull contents, brain appearance, and density on postmortem computed tomography in naturally mummified corpses. For this purpose, a retrospective multicentric study, including mummified corpses from two French centers (Brest and Nantes) and from the New Mexico Decedent Image Database (USA), was performed by analyzing postmortem computed tomography (PMCT) focused on the head and neck of partially or fully mummified corpses discovered between 2011 and 2022. The PMCT analysis provided data on the CT appearance of brains, allowing them to be classified into four different categories (desiccation, liquefaction, dura mater only (DMO), and absence), and to measure densities (HU) of the brain remains. In addition, data on post-mortem intervals (PMI) from Nantes and Brest centers were collected and analyzed to test the link between brain densities and PMIs. 54 cases of naturally mummified corpses were included. The brains were classified as liquefied (56%), desiccated (17%), DMO (20%), and absent (7%) based on their CT appearance. Dehydrated brains were significantly (p<0.004) denser (median 102 HU, interquartile range (IQR) 41) than either liquefied brains (median 39.5 HU, IQR 9) or brains with DMO (median -25 HU, IQR 57). However, the density of brain remains was not significantly affected by where the bodies were found (p = 0,41). Analysis of PMI and brain densities was performed on 22 cases. The results showed that brain remains were significantly (p = 0.039) denser when they were found after a PMI of more than six months. Brain desiccation was the aspect with the highest densities on PMCT, and for which we were able to highlight great preservation of anatomical structures observable in living organisms.

The cardiothoracic ratio on postmortem CT as a screening tool for cardiomegaly in the Thai population.

IntroductionIn forensic radiology, the cardiothoracic ratio (CTR) calculated from postmortem computed tomography (PMCT) images can be used to detect cardiomegaly. In this study, a new measurement method is studied that involves measurement in the anteroposterior (AP) and transverse directions, with a reference level based on the Thai population. ObjectiveTo screen for cardiomegaly using the CTR calculated from PMCT images. Research methodA sample size of 116 deceased Thai individuals who underwent PMCT before autopsy was obtained. Individuals were divided into two groups: normal heart weight and overweight heart. Hearts heavier than the mean plus one standard deviation were categorized into the overweight group. The CTR was calculated in both the AP and transverse directions at six reference levels. Receiver operating characteristic curves (ROC) were calculated to determine the CTR cutoff point for the diagnosis of cardiomegaly. ResultsThe CTR cutoff values for diagnosing cardiomegaly were as follows: 1) CTR >0.5 in the transverse direction at the mid-vertebra of T7 (sensitivity, 75.6%; specificity, 70.6%; area under the ROC curve 0.81), 2) CTR >0.49 in the transverse direction at the mid-vertebra of T8 (sensitivity 71%, specificity 81.4%, area under the ROC curve 0.80). The selection of the cutoff values depended on the location of the heart. The area under the ROC curve in the AP direction was in the range 0.5-0.7, which is inferior compared to the transverse direction (0.7-0.9). ConclusionCalculating the CTR with a reference level on PMCT images can assist in the diagnosis of cardiomegaly.

Development of a deep-learning algorithm for age estimation on CT images of the vertebral column

PurposeThe accurate age estimation of cadavers is essential for their identification. However, conventional methods fail to yield adequate age estimation especially in elderly cadavers. We developed a deep learning algorithm for age estimation on CT images of the vertebral column and checked its accuracy. MethodFor the development of our deep learning algorithm, we included 1,120 CT data of the vertebral column of 140 patients for each of 8 age decades. The deep learning model of regression analysis based on Visual Geometry Group-16 (VGG16) was improved in its estimation accuracy by bagging. To verify its accuracy, we applied our deep learning algorithm to estimate the age of 219 cadavers who had undergone postmortem CT (PMCT). The mean difference and the mean absolute error (MAE), the standard error of the estimate (SEE) between the known- and the estimated age, were calculated. Correlation analysis using the intraclass correlation coefficient (ICC) and Bland-Altman analysis were performed to assess differences between the known- and the estimated age. ResultsFor the 219 cadavers, the mean difference between the known- and the estimated age was 0.30 years; it was 4.36 years for the MAE, and 5.48 years for the SEE. The ICC (2,1) was 0.96 (95 % confidence interval: 0.95–0.97, p < 0.001). Bland-Altman analysis showed that there were no proportional or fixed errors (p = 0.08 and 0.41). ConclusionsOur deep learning algorithm for estimating the age of 219 cadavers on CT images of the vertebral column was more accurate than conventional methods and highly useful.

Utility and limitations of postmortem computed tomography in animal abuse suspected cases: A case series study of cats

ObjectivesInjuries caused by animal abuse are termed non-accidental injuries, and should be distinguished from accidental injuries. We compared postmortem computed tomography (PMCT) and necropsy findings in deceased cat bodies suspected of having been abused to determine whether findings previously reported to be associated with abuse or accident could be ascertained by necropsy or PMCT. Materials and methodsSeven deceased cat bodies requested by the police for necropsy because of suspicion of animal abuse were used to compare necropsy and PMCT findings. ResultsPMCT revealed gas distribution abnormalities, such as pneumocephalus and pneumothorax, and bone lesions findings, such as cervical and pelvic fracture; however, several of these were not confirmed at necropsy. Findings such as liver contusion and injury to the posterior vena cava were confirmed only by necropsy and not by PMCT. Findings related to animal abuse, i.e., ocular injuries, skull, bilateral rib, and femoral fractures were confirmed by both PMCT and necropsy in 3, 5, 2, and 2 cats, respectively. Pneumothorax, pelvic fracture, and sacroiliac luxation, related to accidents, were confirmed only by CT in 6 of 6, 1 of 4, and 2 of 2 bodies. ConclusionPMCT revealed gas- and some bone-related findings more efficiently than necropsy, and a combination of PMCT and necropsy is recommended to perform, particularly if the death circumstances is unknown.

Post-mortem skeletal survey (PMSS) versus post-mortem computed tomography (PMCT) for the detection of corner metaphyseal lesions (CML) in children.

Corner metaphyseal lesions (CMLs) are specific for child abuse but challenging to detect on radiographs. The accuracy of CT for CML detection is unknown. Our aim was to compare diagnostic accuracy for CML detection on post-mortem skeletal surveys (PMSS, plain radiography) versus post-mortem CT (PMCT). A 10-year retrospective review was performed at a children's hospital for patients having PMSS, PMCT and histopathological correlation (reference standard) for suspected CMLs. Twenty-four radiologists independently reported the presence or absence of CMLs in all cases in a blinded randomised cross-over design across two rounds. Logistic regression models were used to compare accuracy between modalities. Twenty CMLs were reviewed for each of the 10 subjects (200 metaphyses in all). Among them, 20 CMLs were confirmed by bone histopathology. Sensitivity for these CMLs was significantly higher for PMSS (69.6%, 95% CI 61.7 to 76.7) than PMCT (60.5%, 95% CI 51.9 to 68.6). Using PMSS for detection of CMLs would yield one extra correct diagnosis for every 11.1 (95% CI 6.6 to 37.0) fractured bones. In contrast, specificity was higher on PMCT (92.7%, 95% CI 90.3 to 94.5) than PMSS (90.5%, 95% CI 87.6 to 92.8) with an absolute difference of 2.2% (95% CI 1.0 to 3.4, p < 0.001). More fractures were reported collectively by readers on PMSS (785) than on PMCT (640). PMSS remains preferable to PMCT for CML evaluation. Any investigation of suspected abuse or unexplained deaths should include radiographs of the limbs to exclude CMLs. In order to avoid missing evidence that could indicate child abuse as a contributory cause for death in children, radiographs of the limbs should be performed to exclude CMLs, even if a PMCT is being acquired. • Corner metaphyseal lesions (CMLs) are indicative for abuse, but challenging to detect. Skeletal surveys (i.e. radiographs) are standard practice; however, accuracy of CT is unknown. • Sensitivity for CML detection on radiographs is significantly higher than CT. • Investigation of unexplained paediatric deaths should include radiographs to exclude CMLs even if CT is also being performed.

Development of A Micro-CT Scanner with Dual-Energy Option and Endovascular Contrast Agent Administration Protocol for Fetal and Neonatal Virtual Autopsy.

The rate of parental consent for fetal and perinatal autopsy is decreasing, whereas parents are more likely to agree to virtual autopsy by non-invasive imaging methods. Fetal and perinatal virtual autopsy needs high-resolution and good soft-tissue contrast for investigation of the cause of death and underlying trauma or pathology in fetuses and stillborn infants. This is offered by micro-computed tomography (CT), as opposed to the limited resolution provided by clinical CT scanners, and this is one of the most promising tools for non-invasive perinatal postmortem imaging. We developed and optimized a micro-CT scanner with a dual-energy imaging option. It is dedicated to post-mortem CT angiography and virtual autopsy of fetuses and stillborn infants in that the chamber can be cooled down to around 5 °C; this increases tissue rigidity and slows decomposition of the native specimen. This, together with the dedicated gantry-based architecture, attempts to reduce potential motion artifacts. The developed methodology is based on prior endovascular injection of a BaSO4-based contrast agent. We explain the design choices and considerations for this scanner prototype. We give details of the treatment of the optimization of the dual-energy and virtual mono-energetic imaging option that has been based on minimizing noise propagation and maximizing the contrast-to-noise ratio for vascular features. We demonstrate the scanner capabilities with proof-of-concept experiments on phantoms and stillborn piglets.

U-Net-Based Automatic Segmentation of Sphenoid Sinus Fluid in Drowning Cases Using Postmortem CT Images: A Feasibility Study

Detecting sphenoid sinus fluid (SSF) is an additional finding in autopsies for diagnosing drowning. SSF can provide additional forensic evidence through laboratory tests such as diatom and electrolyte analyses. If drowning is suspected, accurately assessing the presence and volume of SSF during an autopsy is crucial. Utilizing postmortem computed tomography (PMCT) images could aid in accurately sampling SSF. Accurately segmenting the region of interest is essential for volume analysis using computed tomography images. However, manual segmentation techniques are labor-intensive and time-consuming, and their success depends on the experience of the observer. Therefore, this study aimed to develop a U-Net–based deep learning model for the automatic segmentation of SSF in drowning cases using PMCT images and to evaluate the performance of the model. We retrospectively reviewed 34 drowning cases in which both PMCT scans and forensic autopsies were performed at our institution. The U-Net architecture of deep learning was used for automatic segmentation. The proposed model achieved the Dice similarity coefficient (DSC) and Intersection over Union (IoU) of a maximum of 95.85% and 92.03%, a minimum of 0% and 0%, and an average of 77.15% and 67.18%, respectively. Although the average DSC and IoU did not show high similarity, this study showed that PMCT images can be used for automatic segmentation of SSF in drowning cases, which could improve the performance with sufficient dataset acquisition and further model training.

Subject-specific finite element head models for skull fracture evaluation-a new tool in forensic pathology.

Post-mortem computed tomography (PMCT) enables the creation of subject-specific 3D head models suitable for quantitative analysis such as finite element analysis (FEA). FEA of proposed traumatic events is an objective and repeatable numerical method for assessing whether an event could cause a skull fracture such as seen at autopsy. FEA of blunt force skull fracture in adults with subject-specific 3D models in forensic pathology remains uninvestigated. This study aimed to assess the feasibility of FEA for skull fracture analysis in routine forensic pathology. Five cases with blunt force skull fracture and sufficient information on the kinematics of the traumatic event to enable numerical reconstruction were chosen. Subject-specific finite element (FE) head models were constructed by mesh morphing based on PMCT 3D models and A Detailed and Personalizable Head Model with Axons for Injury Prediction (ADAPT) FE model. Morphing was successful in maintaining subject-specific 3D geometry and quality of the FE mesh in all cases. In three cases, the simulated fracture patterns were comparable in location and pattern to the fractures seen at autopsy/PMCT. In one case, the simulated fracture was in the parietal bone whereas the fracture seen at autopsy/PMCT was in the occipital bone. In another case, the simulated fracture was a spider-web fracture in the frontal bone, whereas a much smaller fracture was seen at autopsy/PMCT; however, the fracture in the early time steps of the simulation was comparable to autopsy/PMCT. FEA might be feasible in forensic pathology in cases with a single blunt force impact and well-described event circumstances.

Automated detection of fatal cerebral haemorrhage in postmortem CT data.

During the last years, the detection of different causes of death based on postmortem imaging findings became more and more relevant. Especially postmortem computed tomography (PMCT) as a non-invasive, relatively cheap, and fast technique is progressively used as an important imaging tool for supporting autopsies. Additionally, previous works showed that deep learning applications yielded robust results for in vivo medical imaging interpretation. In this work, we propose a pipeline to identify fatal cerebral haemorrhage on three-dimensional PMCT data. We retrospectively selected 81 PMCT cases from the database of our institute, whereby 36 cases suffered from a fatal cerebral haemorrhage as confirmed by autopsy. The remaining 45 cases were considered as neurologically healthy. Based on these datasets, six machine learning classifiers (k-nearest neighbour, Gaussian naive Bayes, logistic regression, decision tree, linear discriminant analysis, and support vector machine) were executed and two deep learning models, namely a convolutional neural network (CNN) and a densely connected convolutional network (DenseNet), were trained. For all algorithms, 80% of the data was randomly selected for training and 20% for validation purposes and a five-fold cross-validation was executed. The best-performing classification algorithm for fatal cerebral haemorrhage was the artificial neural network CNN, which resulted in an accuracy of 0.94 for all folds. In the future, artificial neural network algorithms may be applied by forensic pathologists as a helpful computer-assisted diagnostics tool supporting PMCT-based evaluation of cause of death.

Distinguishing true from pseudo hematoma in the cervical spinal canal using post-mortem computed tomography

Spinal cord injury is difficult to detect directly on postmortem computed tomography (PMCT) and it is usually diagnosed by indirect findings such as a hematoma in the spinal canal. However, we have encountered cases where the hematoma-like high-attenuation area in the cervical spinal canal was visible on PMCT, while no hematoma was observed at autopsy; we called it a “pseudo hematoma in the cervical spinal canal (pseudo-HCSC).” In this retrospective study, we performed statistical analysis to distinguish true from pseudo-HCSC. The cervical spinal canal was dissected in 35 autopsy cases with a hematoma-like high-attenuation area (CT values 60-100 Hounsfield Unit (HU)) in the spinal canal from the first to the fourth cervical vertebrae in axial slices of PMCT images. Of these 22 had a hematoma and 13 did not (pseudo-HCSC). The location and length of the hematoma-like high-attenuation and spinal cord areas were assessed on reconstructed PMCT images, true HCSC cases had longer the posterior hematoma-like area and shorter the spinal cord area in the midline of the spinal canal (P < 0.05). Furthermore, we found that true HCSC cases were more likely to have fractures and gases on PMCT while pseudo-HCSC cases were more likely to have significant facial congestion (P < 0.05). We suggest that pseudo-HCSC on PMCT is related to congestion of the internal vertebral venous plexus. This study raises awareness about the importance of distinguishing true HCSC from pseudo-HCSC in PMCT diagnosis, and it also presents methods for differentiation between these two groups.

Postmortem computed tomography (PMCT) is a reliable, reproducible and accurate method in measuring body length

Postmortem computed tomography (PMCT) is a reliable, reproducible and accurate method in measuring body length

A stamped head? Or a coincidental finding? A post-mortem computed tomography (PMCT) case report

A stamped head? Or a coincidental finding? A post-mortem computed tomography (PMCT) case report

Cerebral air embolism following blunt chest trauma diagnosed on post-mortem CT

Cerebral air embolism following blunt chest trauma diagnosed on post-mortem CT

The usability of postmortem CT head as a means of identification

The usability of postmortem CT head as a means of identification