Quantification of interstitial fluid on whole body CT: comparison with whole body autopsy

• Published in: Forensic science, medicine, and pathology medicine, and pathology, 2015-12, Vol.11 (4), p.488-496
• Main Authors: Lo Gullo, Roberto, Mishra, Shelly, Lira, Diego A., Padole, Atul, Otrakji, Alexi, Khawaja, Ranish Deedar Ali, Pourjabbar, Sarvenaz, Singh, Sarabjeet, Shepard, Jo-Anne O., Digumarthy, Subba R., Kalra, Mannudeep K., Stone, James R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ascites - diagnostic imaging; Ascites - pathology; Autopsy; Bilirubin - analysis; Cadaver; Criminology and Criminal Justice; Edema - diagnostic imaging; Edema - pathology; Extracellular Fluid - metabolism; Female; Forensic Medicine; Forensic Pathology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography; Original Article; Pathology; Pericardium - diagnostic imaging; Pericardium - metabolism; Pericardium - pathology; Peritoneum - diagnostic imaging; Peritoneum - metabolism; Peritoneum - pathology; Pleura - diagnostic imaging; Pleura - metabolism; Pleura - pathology; Pleural Effusion - diagnostic imaging; Pleural Effusion - pathology; Serum Albumin - analysis; Severity of Illness Index; Subcutaneous Tissue - diagnostic imaging; Subcutaneous Tissue - metabolism; Subcutaneous Tissue - pathology; Whole Body Imaging
• ISSN: 1547-769X; 1556-2891
• DOI: 10.1007/s12024-015-9728-y

Purpose Interstitial fluid accumulation can occur in pleural, pericardial, and peritoneal spaces, and subcutaneous tissue planes. The purpose of the study was to assess if whole body CT examination in a postmortem setting could help determine the presence and severity of third space fluid accumulation in the body. Materials and methods Our study included 41 human cadavers (mean age 61 years, 25 males and 16 females) who had whole-body postmortem CT prior to autopsy. All bodies were maintained in the morgue in the time interval between death and autopsy. Two radiologists reviewed the whole-body CT examinations independently to grade third space fluid in the pleura, pericardium, peritoneum, and subcutaneous space using a 5-point grading system. Qualitative CT grading for third space fluid was correlated with the amount of fluid found on autopsy and the quantitative CT fluid volume, estimated using a dedicated software program (Volume, Syngo Explorer, Siemens Healthcare). Results Moderate and severe peripheral edema was seen in 16/41 and 7/41 cadavers respectively. It is not possible to quantify anasarca at autopsy. Correlation between imaging data for third space fluid and the quantity of fluid found during autopsy was 0.83 for pleural effusion, 0.4 for pericardial effusion and 0.9 for ascites. The degree of anasarca was significantly correlated with the severity of ascites ( p