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01-06-2014 | Forensic Medicine

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

Authors: Sebastian Winklhofer, Eddie Surer, Garyfalia Ampanozi, Thomas Ruder, Paul Stolzmann, Marina Elliott, Andrea Oestreich, Thomas Kraemer, Michael Thali, Hatem Alkadhi, Wolf Schweitzer

Published in: European Radiology | Issue 6/2014

Abstract

Objective

To investigate frequent findings in cases of fatal opioid intoxication in whole-body post-mortem computed tomography (PMCT).

Methods

PMCT of 55 cases in which heroin and/or methadone had been found responsible for death were retrospectively evaluated (study group), and were compared with PMCT images of an age- and sex-matched control group. Imaging results were compared with conventional autopsy.

Results

The most common findings in the study group were: pulmonary oedema (95 %), aspiration (66 %), distended urinary bladder (42 %), cerebral oedema (49 %), pulmonary emphysema (38 %) and fatty liver disease (36 %). These PMCT findings occurred significantly more often in the study group than in the control group (p < 0.05). The combination of lung oedema, brain oedema and distended urinary bladder was seen in 26 % of the cases in the study group but never in the control group (0 %). This triad, as indicator of opioid-related deaths, had a specificity of 100 %, as confirmed by autopsy and toxicological analysis.

Conclusions

Frequent findings in cases of fatal opioid intoxication were demonstrated. The triad of brain oedema, lung oedema and a distended urinary bladder on PMCT was highly specific for drug-associated cases of death.

Key Points

• Frequent findings in cases of fatal opioid intoxication were investigated.

• Lung oedema, brain oedema and full urinary bladder represent a highly specific constellation.

• This combination of findings in post-mortem CT should raise suspicion of intoxication.

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Title: Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy
Authors: Sebastian Winklhofer
Eddie Surer
Garyfalia Ampanozi
Thomas Ruder
Paul Stolzmann
Marina Elliott
Andrea Oestreich
Thomas Kraemer
Michael Thali
Hatem Alkadhi
Wolf Schweitzer
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3128-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

Abstract

Objective

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

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