Postmortem CT scan in intoxication cases: A necessity or just an indulgence

Author:

Soon Lai Poh1,Subramaniam Kunasilan1,Madon Nor Fadhilah1,Noor Mohamad Helmee Mohamad1,Singh Mansharan Kaur Chainchel2,Mahmood Mohd Shah1

Affiliation:

1. Department of Forensic Medicine, National Institute of Forensic Medicine, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur

2. Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForm), Universiti Teknologi MARA (UiTM), Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh, Selangor, Malaysia, Aras 4, Bangunan Akademik, Kampus Sungai Buloh, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia

Abstract

Abstract Introduction: The aim of this study is to correlate urinary bladder distension and pulmonary edema on postmortem computed tomography (CT) scans with toxicology results in postmortem cases. Methods and Results: The study population was the postmortem cases of Asian population ranging from 16 to 75 years old in which blood and/or urine samples sent for alcohol and/or drug of abuse (DoA) analysis in year 2016 at our centre. Out of 434 cases, 54 from each group of positive and negative alcohol and/or DoA. Postmortem findings of lungs and postmortem CT scan urinary bladder volume (UBV) were recorded. Statistical significant correlation was obtained between urinary bladder distension on postmortem CT scan and cases with positive alcohol detection. However, the sensitivity was relatively low at 51.7%, whereas the specificity was 75% at the cut-off point. Low sensitivity and specificity at around 52.7% were obtained for pulmonary edema related to alcohol/DoA. This showed that UBV alone or pulmonary edema alone was not really a good indicator for alcohol or DoA intoxication. However, combination of both indicators provided higher sensitivity (73.3%) although specificity was lowered to 53.8%. Conclusion: The findings of postmortem CT scan bladder distension and pulmonary edema could possibly identify intoxication cases but not conclusive.

Publisher

Georg Thieme Verlag KG

Subject

Radiology, Nuclear Medicine and imaging

Reference9 articles.

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