Comparison of CT Values between Thrombus and Postmortem Clot Based on Cadaveric Pulmonary Angiography

doi:10.12116/j.issn.1004-5619.2022.420514

Abstract

Abstract:

Objective To explore the difference in CT values between pulmonary thromboembolism and postmortem clot in postmortem CT pulmonary angiography （CTPA） to further improve the application value of virtual autopsy. Methods Postmortem CTPA data with the definite cause of death from 2016 to 2019 were collected and divided into pulmonary thromboembolism group （n=4）, postmortem clot group （n=5）, and control group （n=5）. CT values of pulmonary trunk and left and right pulmonary artery contents in each group were measured and analyzed statistically. Results The average CT value in the pulmonary thromboembolism group and postmortem clot group were （168.4±53.8） Hu and （282.7±78.0） Hu, respectively, which were lower than those of the control group （1 193.0±82.9） Hu （P<0.05）. The average CT value of the postmortem clot group was higher than that of the pulmonary thromboembolism group （P<0.05）. Conclusion CT value is reliable and feasible as a relatively objective quantitative index to distinguish pulmonary thromboembolism and postmortem clot in postmortem CTPA. At the same time, it can provide a scientific basis to a certain extent for ruling out pulmonary thromboembolism deaths.

Key words: forensic pathology, virtual autopsy, postmortem CT pulmonary angiography, pulmonary thromboembolism, postmortem clot, CT value

CLC Number:

DF795.1

Zhi-ling TIAN, Ruo-lin WANG, Jian-hua ZHANG, Ping HUANG, Zhi-qiang QIN, Zheng-dong LI, He-wen DONG, Dong-hua ZOU, Mao-wen WANG, Zhuo LI, Lei WAN, Xiao-tian YU, Ning-guo LIU. Comparison of CT Values between Thrombus and Postmortem Clot Based on Cadaveric Pulmonary Angiography[J]. Journal of Forensic Medicine, 2023, 39(1): 7-12.

Figures/Tables 4

Tab. 1 The cases information

组别	案例	性别	年龄/岁	尸体腐败程度	死后经历时间/d	死亡原因
肺动脉血栓	1	男	68	轻度	4	交通事故损伤并发肺动脉血栓栓塞
	2	女	71	轻度	10	交通事故损伤并发肺动脉血栓栓塞
	3	女	58	轻度	5	交通事故损伤并发肺动脉血栓栓塞
	4	男	41	未见明显腐败	1	交通事故损伤并发肺动脉血栓栓塞
死后凝血块	5	男	39	轻度	10	摔跌致颅脑损伤
	6	女	46	轻度	2	头、颈部损伤并发肺部感染
	7	女	45	未见明显腐败	1	电击死
	8	男	25	轻度	12	交通事故致高位颈髓损伤
	9	男	66	轻度	6	扩张型心肌病
对照	10	男	45	未见明显腐败	2	硫化氢中毒
	11	男	61	轻度	6	冠状动脉粥样硬化性心脏病
	12	女	57	轻度	3	外伤性脾破裂致失血性休克
	13	男	36	轻度	5	急性乙醇中毒
	14	女	47	未见明显腐败	4	外伤性蛛网膜下腔出血

Fig. 1 Schematic diagram of CT value measurement

Fig. 2 Comparison between the results of postmortem CTPA （the axial position） and autopsy

Tab. 2 Measurement analysis results of CT values in different groups

组别	案例数	CT值测量次数/例	CT值/Hu			ROI面积/cm²
组别	案例数	CT值测量次数/例	$x ˉ$ ±s	最大值	最小值	ROI面积/cm²
肺动脉血栓	4	21	168.4±53.8^1）	275.0	67.0	0.069~0.843
死后凝血块	5	23	282.7±78.0^1）2）	453.0	158.9	0.087~0.665
对照	5	16	1 193.0±82.9	1 376.0	1 040.0	0.287~1.215

Tab. 2 Measurement analysis results of CT values in different groups

组别	案例数	CT值测量次数/例	CT值/Hu			ROI面积/cm²
组别	案例数	CT值测量次数/例	$x ˉ$ ±s	最大值	最小值	ROI面积/cm²
肺动脉血栓	4	21	168.4±53.8^1）	275.0	67.0	0.069~0.843
死后凝血块	5	23	282.7±78.0^1）2）	453.0	158.9	0.087~0.665
对照	5	16	1 193.0±82.9	1 376.0	1 040.0	0.287~1.215

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