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8 - Post-mortem imaging – an update

Published online by Cambridge University Press:  06 January 2010

Nigel Kirkham
Affiliation:
Royal Victoria Infirmary, Newcastle
Neil A. Shepherd
Affiliation:
Gloucestershire Royal Hospital
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Summary

INTRODUCTION

There have been huge advances in clinical imaging over the last 10 years that have resulted in an improvement in the visualisation of both morphological and functional pathology.

Imaging techniques have been used to identify bone injury ever since Roentgen produced the first radiograph in 1895. Most of us are familiar with the ongoing utility of X-rays in both paediatric and adult pathology, particularly in a medico-legal context. Skeletal surveys are used to identify fractures in cases of suspected child abuse and to demonstrate bone trauma associated with bullets and other missiles.

In the second half of the 20th Century, more sophisticated imaging techniques were introduced. Computed Axial Tomography (CAT) scans (now Computed Tomography (CT) scans) were introduced in the early 1970s, followed by magnetic resonance imaging (MRI), nuclear medicine and positron emission tomography (PET). Each modality is used in different ways in clinical medicine, maximising their respective strengths and cost-effectiveness.

Autopsy rates, already in decline in England and Wales and elsewhere since the 1950s, further plummeted in the wake of the Alder Hey and Bristol tissue and organ ‘scandals’ of the late 1990s [1]–[3].

There has been an increased interest in the application of clinical imaging techniques to post-mortem diagnoses, either as an adjunct to, or as a replacement of the autopsy [4], [5].

Some of this research has been prompted by certain religious communities, whose attitudes to autopsy have previously been explored in detail [6], [7].

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Progress in Pathology , pp. 199 - 220
Publisher: Cambridge University Press
Print publication year: 2007

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References

Start RD, Cotton DWK. The current status of the autopsy. In Progress in Pathology 3. Kirkham, N, Lemoine, NR (Eds.) (Churchill Livingstone, Edinburgh 1997) pp. 179–88.Google Scholar
Rutty, GN, Duerdon, RM, Carter, Net al. Are coroners' necropsies necessary? A prospective study examining whether a ‘view and grant’ system of death certification could be introduced into England and Wales. J Clin Pathol 2001; 54: 279–84.CrossRefGoogle Scholar
Burton, JL, Underwood, JCE. Necropsy practice after the ‘organ retention scandal’: requests, performance, and tissue retention. J Clin Patho 2003; 56: 537–41.CrossRefGoogle Scholar
Handley, R. Postmortem imaging: a viable alternative to autopsy … or just a dead end?Adv Imaging April 2001; 10–11.Google Scholar
Eustace, SJ, Nelson, E. Whole body magnetic resonance imaging – a valuable adjunct to clinical examination. BMJ 2004; 328: 1387–8.CrossRefGoogle Scholar
Bisset, RAL, Thomas, NB, Turnbull IW et al. Postmortem examinations using magnetic resonance imaging: four year review of a working service. BMJ 2002; 324: 1423–4.CrossRefGoogle ScholarPubMed
Geller, SA. Religious attitudes and the autopsy. Arch Pathol Lab Med 1984; 108: 494–6.Google ScholarPubMed
Redfern M. The Royal Liverpool Children's Hospital Inquiry, 2000, www.rlcinquiry.org.uk.
Kennedy I. Learning from Bristol. Inquiry into the Management of Care of Children Receiving Complex Heart Surgery at the Bristol Royal Infirmary, 2001, www.bristol-inquiry.org.uk/final_report/.
Department of Health. The Removal, Retention and Use of Human Organs and Tissue from Post-Mortem Examinations: Advice from the Chief Medical Officer, 2001, The Stationery Office, London UK.
Parker A. Less invasive autopsy – the place of magnetic resonance imaging, 2004, www.publications.doh.gov.uk/cmo/progress/organretention/mri-report.pdf.
Department of Health. Policy Research Programme Invitation to Tender – Less Invasive Autopsy. Calls for proposals document available on-line, 2004, www.dh.gov.uk/ProcurementAndProposals/RDCallsForProposals/fs/en.
Home Office. Reforming the Coroner and Death Certification Service – A Position Paper, Cm 6159, The Stationery Office, London, March 2004.
Luce T. Death Certification and Investigation in England, Wales and Northern Ireland – The Report of a Fundamental Review. Cm 58 2003, The Stationery Office, www.official-documents.co.uk/document/cm58/5831/5831.htm.
Smith J. The Shipman Inquiry – Third Report: Death Certification and the investigation of Deaths by Coroners, 2003, www.the-shipman-inquiry.org.uk/thirdreport.asp.
Department of Health. Policy Research Programme Invitation to Tender – Less Invasive Autopsy. Advert inBMJ Careers 3/4/04 p. a3.
Benbow, EW, Roberts, ISD. The autopsy: complete or not complete?Histopathol 2003; 42: 417–23.CrossRefGoogle ScholarPubMed
Thali MJ, Vock P. Role and techniques in forensic imaging. In Forensic Medicine – Clinical and Pathological Aspects. Payne-James, JJ, Bussuttil, A, Smock, W (Eds.) (Greenwich Medical Media, London, 2003) 731–47.Google Scholar
Ehrlich, E, Maxeiner, H, Lange, J. Postmortem radiological investigation of bridging vein ruptures. Leg Med 2003; 5: S225–S7.CrossRefGoogle ScholarPubMed
Prahlow, JA, Scharling, ES, Lantz, P. Postmortem coronary subtraction angiography. Am J Foren Med Pathol 1996; 17: 225–30.CrossRefGoogle ScholarPubMed
Garden, AS, Weindling, AM, Griffiths, RDet al. Fast-scan magnetic resonance imaging of fetal anomalies. Am J Obstet Gynaecol 1991; 166: 1217–22.Google Scholar
Brookes, JAS, Hall-Craggs, MA, Sama, VRet al. Non-invasive perinatal necropsy by magnetic resonance imaging. Lancet 1996; 348: 1139–41.CrossRefGoogle ScholarPubMed
Woodward, PJ, Sohaey, R, Harris, DPet al. Postmortem fetal MR imaging: comparison with findings at autopsy. AJR 1997; 168: 41–6.CrossRefGoogle ScholarPubMed
Alderliesten, ME, Peringa, J, Hulst, VPMet al. Perinatal mortality: clinical value of postmortem magnetic resonance imaging compared with autopsy in routine obstetric practice. BJ Obs Gyn 2003; 110: 378–82.CrossRefGoogle ScholarPubMed
Guo, WY, Chang, CY, Ho, DMet al. A comparative MRI and pathological study on CNS disorders. Child Nerv Sys 2003; 17: 512–18.CrossRefGoogle Scholar
Huisman, TAGM, Wisser, J, Stallmach, Tet al. MR autopsy in fetuses. Fet Diag Ther 2002; 17: 58–64.CrossRefGoogle ScholarPubMed
Griffiths, PD, Variend, D, Evans, Met al. Postmortem MR imaging of the fetal and stillborn central nervous system. Am J Neuroradiol 2003; 24: 22–7.Google ScholarPubMed
Royal College of Paediatrics and Child Health. The Future of Paediatric Pathology Services, 2002, www.rcpch.ac.uk/publications/recent_publications/Pathol.pdf.
Ros, PR, Li, KC, Vo, Pet al. Pre-autopsy magnetic resonance imaging: initial experience. Magnet Res Imag 1990; 8: 303–8.CrossRefGoogle Scholar
Sheppard MN. Sudden adult death and the heart. In Progress in Pathology 6. Kirkham, N., Shepherd, N (Eds.) (Greenwich Medical Media, London, 2003) pp. 185–202.Google Scholar
Sheppard, MN. The autopsy. Letter to editor, Histopathol 2004; 44: 82–3.CrossRefGoogle Scholar
Swift, B. Postmortem radiology is useful but no substitute for necropsy. Letter to editor. BMJ 2002; 325: 549.CrossRefGoogle Scholar
Jarmulowicz MR. MRI postmortems – no validation. bmj.com rapid responses for Bisset et al. 2002; 324 (7351): 1423–4, available on-line 17/6/02 www.bmj.bmjjournals.com/cgi/eletters/324/7351/1423.
Bell JE, Ironside JW, Smith C. Letter in response to Bisset et al., bmj.com rapid responses for Bisset et al. 2002; 324 (7351): 1423–4, available on-line 4/7/02 www.bmj.bmjjournals.com/cgi/eletters/324/7351/1423.
Leadbeatter S, James R, Davison A et al. Many more questions than answers. bmj.com rapid responses for Bisset et al. 2002; 324 (7351): 1423–4, available on-line 5/7/02 www.bmj.bmjjournals.com/cgi/eletters/324/7351/1423.
Salmon D. It is a mad, mad world, my masters. bmj.com rapid responses for Bisset et al. 2002; 324 (7351): 1423–4, available on-line 14/6/02 www.bmj.bmjjournals.com/cgi/eletters/324/7351/1423.
Roberts, ISD, Benbow, EW, Bisset, Ret al. Accuracy of magnetic resonance imaging in determining cause of sudden death in adults: comparison with conventional autopsy. Histopathol 2003; 42: 424–30.CrossRefGoogle ScholarPubMed
Yamazaki, K, Shiotani, S, Ohashi, Net al. Hepatic portal venous gas and hyper-dense aortic wall as postmortem computed tomography finding. Leg Med 2003; 5: S338–41.CrossRefGoogle ScholarPubMed
Patriquin, L, Kassarjian, A, O'Brien, Met al. Postmortem whole-body magnetic resonance imaging as an adjunct to autopsy: preliminary clinical experience. J Magnet Res Imag 2001; 13: 277–87.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Bronge, L, Bogdanovic, N, Wahlund, LO. Postmortem MRI and histopathology of white matter changes in Alzheimer brains. A quantitative, comparative study. Dement Geria Cog Dis 2002; 13: 205–12.CrossRefGoogle ScholarPubMed
Messori, A, Salvolini U. Postmortem MRI as a useful tool for investigation of cerebral microbleeds. Letter to Editor, Stroke 2003; 34: 376–7.CrossRefGoogle Scholar
Harris, LS. Postmortem magnetic resonance images of the injured brain: effective evidence in the courtroom. Forens Sci Int 1991; 50: 179–85.CrossRefGoogle ScholarPubMed
Hsu, JCM, Johnson, A, Smith, WMet al. Magnetic resonance imaging of chronic myocardial infarcts in formalin-fixed human autopsy hearts. Circulation 1994; 89: 2133–40.CrossRefGoogle ScholarPubMed
Wallace, SK, Cohen, WA, Stern, EJet al. Judicial hanging: postmortem radiographic, CT, and MR imaging features with autopsy confirmation. Radiology 1994; 193: 263–7.CrossRefGoogle Scholar
Donchin, Y, Rivkind, AI, Bar-Ziv, J, Hiss, Jet al. Utility of postmortem computed tomography in trauma victims. J Trauma 1994; 37: 552–6.CrossRefGoogle ScholarPubMed
Bauer, M, Polzin, S, Patzelt, D. The use of clinical CCT images in the forensic examination of closed head injuries. J Clin Forens Med 2004; 11: 65–70.CrossRefGoogle ScholarPubMed
Gentry, LR, Godersky, JC, Thompson, B. MR imaging of head trauma: review of the distribution and radiopathologic features of traumatic lesions. AJR 1988; 150: 663–72.CrossRefGoogle ScholarPubMed
Hart, B, Dudley, M, Zumwalt, RE. Postmortem cranial MRI and autopsy correlation in suspected child abuse. Am J Forens Med Pathol 1996; 17: 217–24.CrossRefGoogle ScholarPubMed
Thali, MJ, Yen, K, Schweitzer, Wet al. Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) – a feasibility study. J Foren Sci 2003; 48: 386–483.CrossRefGoogle ScholarPubMed
Thali, MJ, Yen, K, Plattner, Tet al. Charred body: virtual autopsy with multi-slice computed tomography and magnetic resonance imaging. J Forens Sci 2002; 47: 1326–31.CrossRefGoogle ScholarPubMed
Thali, MJ, Yen, K, Schweitzer, Wet al. Into the decomposed body – forensic digital autopsy using multislice-computed tomography. Forens Sci Int 2003; 134: 109–17.CrossRefGoogle ScholarPubMed
Plattner, T, Thali, MJ, Yen, Ket al. Virtopsy – Postmortem Multislice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) in a fatal scuba diving incident. J Forens Sci 2003; 48: 1347–55.CrossRefGoogle Scholar
Thali, MJ, Yen, K, Vock, Pet al. Image-guided virtual autopsy findings of gunshot victims performed with multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) and subsequent correlation between radiology and autopsy findings. Forens Sci Int 2003; 138: 8–16.CrossRefGoogle ScholarPubMed
Thali, MJ, Schweitzer, W, Yen, Ket al. New horizons in forensic radiology: the 60-second digital autopsy – full-body examination of a gunshot victim by Multi-slice Computed Tomography. Am J Forens Med Pathol 2003; 24: 22–7.CrossRefGoogle Scholar
Farkash, U, Scope, A, Lynn, Met al. Preliminary experience with postmortem computed tomography in military penetrating trauma. J Trauma: Inj, Inf Crit Care 2000; 48: 303–8.CrossRefGoogle ScholarPubMed
Marchetti, D, Tartaglione, T, Mattiu, Get al. Reconstruction of the angle of shot by using computed radiography of the head. Am J Forens Med Pathol 2003; 24: 155–9.CrossRefGoogle Scholar
Rutty, GN, Swift, B. Correspondence to ‘accuracy of magnetic resonance imaging in determining cause of sudden death in adults’: comparison with conventional autopsy. Histopathol 2004; 44: 187–9.CrossRefGoogle Scholar
Bruschweiler, W, Braun, M, Dirnhofer, Ret al. Analysis of patterned injuries and injury-causing instruments with forensic 3D/CAD supported photogrammetry (FPHG): an instruction manual for the documentation process. Forens Sci Int 2003; 132: 130–8.CrossRefGoogle ScholarPubMed
Thali, MJ, Braun, M, Dirnhofer, R. Optical 3D surface digitising in forensic medicine: 3D documentation of skin and bone injuries. Forens Sci Int 2003; 137: 203–8.CrossRefGoogle Scholar
Thali, MJ, Braun, M, Brueschweiler, Wet al. Morphological imprint: determination of the injury-causing weapon from the wound morphology using forensic 3D/CAD supported photogrammetry. Forens Sci Int 2003; 132: 177–81.CrossRefGoogle ScholarPubMed
Thali, MJ, Braun, M, Bruschweiler, Wet al. Matching tyre tracks on the head using forensic photogrammetry. Forens Sci Int 2000; 113: 281–7.CrossRefGoogle Scholar
Subke, J, Haase, S, Wehner, H-Det al. Computer aided shot reconstructions by means of individualised animated three-dimensional victim models. Forens Sci Int 2002; 125: 245–9.CrossRefGoogle Scholar
Oliver, WR, Boxwala, A, Rosenman, Jet al. Three-dimensional visualisation and image processing in the evaluation of patterned injuries: The AFIP/UNC experience in the Rodney King case. Am J Forens Med Pathol 1997; 18: 1–10.CrossRefGoogle Scholar
March, J, Schofield, D, Evison, Met al. Three-dimensional computer visualisation of forensic pathology data. Am J Forens Med Pathol 2003; 25: 60–70.CrossRefGoogle Scholar
Rosai, J.Rosai and Ackerman's Surgical Pathology. 9th edn, Vol. 1 (Mosby, Philadelphia, 2004); p. 37.
MRPath Incorporated. Magnetic Resonance Histology, 2001, www.mrpath.com/rd/tech/tech.html
Johnson, GA, Benveniste, H, Black, RDet al. Histology by magnetic resonance microscopy. Magnet Res Quart 1993; 9: 1–30.Google ScholarPubMed
Ciobanu, L, Seeber, DA, Pennington, CH. 3D MR microscopy with resolution 3.7 μm by 3.3 μm by 3.3 μm. J Magnet Res 2002; 158: 178–82.CrossRefGoogle Scholar
Blank, A, Dunnam, CR, Borbat, PPet al. High resolution electron spin resonance microscopy. J Magnet Res 2003; 165: 116–27.CrossRefGoogle ScholarPubMed
Emch, B, Singer, T, Rudin, Met al. Magnetic resonance imaging (MRI) – a new diagnostic modality in toxicological studies. Toxicol Let 1996; 88: 47.CrossRefGoogle Scholar
Ith, M, Bigler, P, Scheurer, Eet al. Observation and identification of metabolites emerging during postmortem decomposition of brain tissue by means of in-situ 1H-Magnetic Resonance Spectroscopy. Magnet Res Med 2002; 48: 915–20.CrossRefGoogle ScholarPubMed
Dewey, M. Multislice CT coronary angiography: evaluation of an automatic vessel detection tool. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2004; 176: 478–83.Google ScholarPubMed
CORDA (The Heart Charity). CORDA Asymptomatic Subject Plaque Assessment Research – The CASPAR Project, www.rbh-cmr.org/caspar.htm accessed 22/6/04.

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