Longitudinal comparison of ascites attenuation between antemortem and postmortem computed tomography. (April 2021)

• Record Type: Journal Article
• Authors: Ishida, Masanori; Gonoi, Wataru; Abe, Hiroyuki; Shirota, Go; Fujimoto, Kotaro; Okimoto, Naomasa; Ushiku, Tetsuo; Abe, Osamu
• Is Part Of: Forensic science international. Volume 321(2021)
• Publication Date: 2021-04
• Subjects: Ascites -- Attenuation -- Postmortem computed tomography -- Postmortem imaging -- Forensic radiology; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2021.110727
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: Elevated ascites attenuation on PMCT relative to AMCT was found in subjects who underwent enhanced AMCT shortly before death. Inverse association between the ascites attenuation change and the time interval between enhanced AMCT and PMCT was found. Increased vascular wall permeability and leakage of contrast medium into the ascites may occur near and after death. Abstract: Objective: To investigate the changes in ascites attenuation between antemortem (AMCT) and postmortem computed tomography (PMCT) analyses of the same subjects. Methods: Thirty-five subjects who underwent unenhanced or enhanced AMCT within 7 days before death, unenhanced PMCT, and autopsy were evaluated. In each subject, ascites attenuation was measured at similar sites on AMCT and PMCT. Attenuation changes were evaluated in 42 unenhanced AMCT/PMCT site pairs (23 subjects) and 20 enhanced AMCT/PMCT site pairs (12 subjects). Factors contributing to CT attenuation changes were also assessed, including the time interval between AMCT and PMCT, serum albumin level, estimated glomerular filtration rate, and ascites volume. Results: Significantly elevated CT attenuation was observed between enhanced AMCT and PMCT (12.2 ± 6.3 vs. 18.7 ± 10.4 Hounsfield units; paired t -test, p = 0.006), but not between unenhanced AMCT and PMCT (13.5 ± 8.9 vs. 13.4 ± 9.3; p = 0.554). A significant inverse association was observed between the degree of CT attenuation change and the time interval between enhanced AMCT and PMCT (Spearman's rank correlation coefficient, r = −0.56, p = 0.01). Conclusions: We confirmed an elevated level of ascites attenuation on PMCT relative to AMCT in subjects who underwent enhanced AMCT shortly before death.