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01-06-2013 | Pediatric

Whole-body post-mortem computed tomography compared with autopsy in the investigation of unexpected death in infants and children

Authors: Maïa Proisy, Antoine Jérôme Marchand, Philippe Loget, Renaud Bouvet, Michel Roussey, Fabienne Pelé, Céline Rozel, Catherine Treguier, Pierre Darnault, Bertrand Bruneau

Published in: European Radiology | Issue 6/2013

Abstract

Objectives

To investigate the contribution of whole-body post-mortem computed tomography (PMCT) in sudden unexpected death in infants and children.

Methods

Forty-seven cases of sudden unexpected death in children investigated with radiographic skeletal survey, whole-body PMCT and autopsy were enrolled. For imaging interpretation, non-specific post-mortem modifications and abnormal findings related to the presumed cause of death were considered separately. All findings were correlated with autopsy findings.

Results

There were 31 boys and 16 girls. Of these, 44 children (93.6 %) were younger than 2 years. The cause of death was found at autopsy in 18 cases (38.3 %), with 4 confirmed as child abuse, 12 as infectious diseases, 1 as metabolic disease and 1 as bowel volvulus. PMCT results were in accordance with autopsy in all but three of these 18 cases. Death remains unexplained in 29 cases (61.7 %) and was correlated with no abnormal findings on PMCT in 27 cases. Major discrepancies between PMCT and autopsy findings concerned pulmonary analysis.

Conclusions

Whole-body PMCT may detect relevant findings that can help to explain sudden unexpected death and is essential for detecting non-accidental injuries. We found broad concordance between autopsy and PMCT, except in a few cases of pneumonia. It is a non-invasive technique acceptable to relatives.

Key Points

• Whole-body post-mortem computed tomography (PMCT) is an effective non-invasive method.

• Whole-body PMCT is essential for detecting child abuse in unexpected death.

• There is concordance on cause of death between PMCT and autopsy.

• Whole-body PMCT could improve autopsy through dissection and sampling guidance.

• PMCT shows findings that may be relevant when parents reject autopsy.

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Title: Whole-body post-mortem computed tomography compared with autopsy in the investigation of unexpected death in infants and children
Authors: Maïa Proisy
Antoine Jérôme Marchand
Philippe Loget
Renaud Bouvet
Michel Roussey
Fabienne Pelé
Céline Rozel
Catherine Treguier
Pierre Darnault
Bertrand Bruneau
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: European Radiology / Issue 6/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-012-2738-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Whole-body post-mortem computed tomography compared with autopsy in the investigation of unexpected death in infants and children

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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