Citation

Flach PM, Ross SG, Bolliger SA, Ampanozi G, Hatch GM, Schön C, Thali MJ, Germerott T. J. Forensic Sci. 2012; 57(5): 1376-1380.

Affiliation

Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland. Department of Neuroradiology, Inselspital Bern, University of Bern, 3010 Bern, Switzerland.

Copyright

(Copyright © 2012, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/j.1556-4029.2012.02144.x

PMID

22537470

Abstract

Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy.

Language: en