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Journal Article

Citation

Shimbashi S, Hayata R, Matoba K, Saito A, Matoba T, Takeuchi A, Jin S, Hyodoh H. Leg. Med. (Elsevier) 2023; 60: e102178.

Copyright

(Copyright © 2023, Japanese Society of Legal Medicine, Publisher Elsevier Publishing)

DOI

10.1016/j.legalmed.2022.102178

PMID

unavailable

Abstract

PURPOSE
The purpose of this study was to review the findings of computed tomography (CT) performed early postmortem on infants and to clarify the postmortem CT lung findings that occur in the absence of abnormal histopathological findings.

Materials and methods
From July 2016 to March 2022, 72 infants were autopsied with postmortem CT (41 boys 31 girls, aged 0-36 (mean 8.2) months). Autopsy and postmortem CT lung findings were compared with the causes of death identified by the autopsies, namely sudden infant death syndrome (n = 37), acute circulatory system disease (18), drowning (7), asphyxia (5), and dehydration/undernutrition (5).

Results
The %aerated lung volume (−700 HU or less) ranged from 0 % to 33 % (mean 1.5 %, median 0 %), being <1 % in 61 cases (84.7 %) and >3 % in 3/5 (60 %) of the dehydration/undernutrition group. The dehydration/undernutrition group showed significant preservation of lung field air content compared with the other causes of death groups (p < 0.05). Receiver characteristic curve analysis showed a cut off value of 0.8 % and area under the curve of 0.88806. The drowning group had significantly greater pleural cavity fluid retention than the other causes of death groups (p < 0.05). No correlation was found between postmortem interval and pleural cavity fluid retention. However, resuscitation time and pleural cavity fluid retention were correlated.

Conclusion
Evaluation of CT values on postmortem lung fields of infants usually reveals a marked decrease in air content. When air content exceeds 0.8% on infant postmortem CT, dehydration/undernutrition should be considered in the differential diagnosis.


Language: en

Keywords

Dehydration; Infant; Postmortem computed tomography; Pulmonary; Undernutrition

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