Abstract
Purpose
The purpose of this study was to investigate the cause and significance of intrahepatic gas (IHG).
Materials and methods
There were 208 nontraumatically deceased individuals retrospectively investigated concerning the occurrence and location of IHG by postmortem multislice computed tomography (MSCT) imaging. The location of IHG was graded on a scale from 0 to 3: 0, no gas; 1, gas only in the left lobe; 2, gas in the left lobe and anterior segment of the right lobe; 3, gas in the left lobe and the anterior and posterior segments of the right lobe). We also assessed and noted the occurrence of intestinal distention, airway management, the interval between cardiopulmonary arrest (CPA) and subsequent examination, and the postmortem interval.
Results
IHG was found in 66 cases (31.7%): grade 1, 15 (7.2%); grade 2, 21 (10.1%); grade 3, 30 (14.4%). The presence of IHG was strongly related to intestinal distention and the period between the time of CPA and the examination.
Conclusion
IHG is a frequent finding on postmortem CT in cases of nontraumatic death. The presence of IHG is related to intestinal distention and the interval between the time of CPA and examination.
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References
Mitka M. CT, MRI scans offer new tools for autopsy. JAMA 2007;298:392–393.
O’Donnell C, Rotman A, Collett S, Woodford N. Current status of routine post-mortem CT in Melbourne, Australia. Forensic Sci Med Pathol 2007;3:226–232.
Dirnhofer R, Jackowski C, Vock P, Potter K, Thali MJ. Virtopsy: minimally invasive, imaging-guided virtual autopsy. Radiographics 2006;26:1305–1333.
O’Donnell C, Woodford N. Post-mortem radiology: a new subspeciality? Clin Radiol 2008;63:1189–1194.
Bolliger SA, Thali MJ, Ross S, Buck U, Naether S, Vock P. Virtual autopsy using imaging: bridging radiologic and forensic sciences—a review of the Virtopsy and similar projects. Eur Radiol 2008;18:273–282.
Aghayev E, Sonnenschein M, Jackowski C, Thali M, Buck U, Yen K, et al. Postmortem radiology of fatal hemorrhage: measurements of cross-sectional areas of major blood vessels and volumes of aorta and spleen on MDCT and volumes of heart chambers on MRI. AJR Am J Roentgenol 2006;187:209–215.
Levy AD, Harcke HT, Getz JM, Mallak C, Caruso JL, Pearse L, et al. Virtual autopsy: two- and three- dimensional multi-detector CT findings in drowning with autopsy comparison. Radiology 2007;243:862–868.
Levy AD, Abbott RM, Mallak CT, Getz JM, Harcke HT, Champion HR, et al. Virtual autopsy: preliminary experience in high-velocity gunshot wound victims. Radiol 2006;240:522–528.
Sochor MR, Trowbridge MJ, Boscak A, Maino JC, Maio RF. Postmortem computed tomography as an adjunct to autopsy for analyzing fatal motor vehicle crash injuries: results of a pilot study. J Trauma 2008;65:659–665.
Patriquin L, Kassarjian A, Casserley L, O’Brien M, Andry C, Eustace S. Postmortem whole-body magnetic resonance imaging as an adjunct to autopsy: preliminary clinical experience. J Magn Reson Imaging 2001;13:277–287.
Ezawa H, Yoneyama R, Kandatsu S, Yoshikawa K, Tsuji H, Harigaya K. Introduction of autopsy imaging redefines the concept of autopsy: 37 cases of clinical experience. Pathol Int 2003;53:865–873.
Shiotani S, Kohno M, Ohashi N, Atake S, Yamazaki K, Nakayama H. Cardiovascular gas on non-traumatic postmortem computed tomography (PMCT): the influence of cardiopulmonary resuscitation. Radiat Med 2005;23:225–229.
Shiotani S, Kohno M, Ohashi N, Yamazaki K, Nakayama H, Watanabe K, et al. Dilatation of the heart on postmortem computed tomography (PMCT) comparison with live CT. Radiat Med 2003;21:29–35.
Shiotani S, Kohno M, Ohashi N, Yamazaki K, Nakayama H, Watanabe K, et al. Non-traumatic postmortem computed tomographic (PMCT) findings of the lung. Forensic Sci Int 2004;139:39–48.
Jackowski C, Thali MJ, Aghayev E, Yen K, Sonnenschein M, Zwygart K, et al. Postmortem imaging of blood and its characteristics using MSCT and MRI. Int J Legal Med 2006;120:233–240.
Shiotani S, Kohno M, Ohashi N, Yamazaki K, Itai Y. Postmortem intravascular high-density fluid level (hypostasis): CT findings. J Comp Assist Tomogr 2002;26:892–893.
Shiotani S, Kohno M, Ohashi N, Yamazaki K, Nakayama H, Watanabe K. Postmortem computed tomography (PMCT) demonstration of the relation between gastrointestinal (GI) distension and hepatic portal venous gas (HPVG). Radiat Med 2004;22:25–29.
Yamazaki K, Shiotani S, Ohashi N, Doi M, Honda K. Hepatic portal venous gas and hyper-dense aortic wall as postmortem computed tomography finding. Legal Med 2003;5:338–341.
Jackowski C, Sonnenschein M, Thali MJ, Aghayev E, Yen K, Dirnhofer R, et al. Interhepatic gas at postmortem computed tomography: forensic experience as a potential guide for in vivo trauma imaging. J Trauma 2007;62:979–988.
Chan SC, Wan YL, Cheung YC, Ng SH, Wong AM, Ng KK. Computed tomography findings in fatal cases of enormous hepatic portal venous gas. World J Gastroenterol 2005;11:2953–2955.
Paran H, Epstein T, Gutman M, Feinberg MS, Zissin R. Mesenteric and postal vein gas: computerized tomography findings and clinical significance. Dig Surg 2003;20:127–132.
Sebastia C, Quiroga S, Espin E, Boye R, Alvarez-Castells A, Armengol M. Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics 2000;20:1213–1224.
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Takahashi, N., Higuchi, T., Shiotani, M. et al. Intrahepatic gas at postmortem multislice computed tomography in cases of nontraumatic death. Jap J Radiol 27, 264–268 (2009). https://doi.org/10.1007/s11604-009-0337-0
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DOI: https://doi.org/10.1007/s11604-009-0337-0