Objective evaluation of chest findings in infants by postmortem computed tomography

• Published in: Legal medicine (Tokyo, Japan) Japan), 2023-02, Vol.60, p.102178-102178, Article 102178
• Main Authors: Shimbashi, Shogo, Hayata, Rina, Matoba, Kotaro, Saito, Atsuko, Matoba, Tomoko, Takeuchi, Akiko, Jin, Shigeki, Hyodoh, Hideki
• Format: Article
• Language: English
• Subjects: Dehydration; Dehydration - pathology; Drowning - diagnosis; Female; Humans; Infant; Lung - diagnostic imaging; Lung - pathology; Male; Malnutrition - pathology; Postmortem Changes; Postmortem computed tomography; Pulmonary; Tomography, X-Ray Computed; Undernutrition
• ISSN: 1344-6223; 1873-4162
• DOI: 10.1016/j.legalmed.2022.102178

•There is significant hypostasis in the lung field in 84.7% of infant deaths.•Postmortem CT-assessed lung aeration is significantly preserved in deaths due to dehydration/undernutrition.•Below −700 HU 0.8 and AUC 0.88806 are the thresholds for lung field air content capacity (%) in deaths due to dehydration/undernutrition. 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. 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). The %aerated lung volume (−700 HU or less) ranged from 0 % to 33 % (mean 1.5 %, median 0 %), being 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