Post-mortem computed tomography ventilation; simulating breath holding

• DOI: 10.1007/s00414-013-0943-3
• Publication Date: 2013-11-25T08:34:14Z
• Authors: C. Robinson; M. J. Biggs; J. Amoroso; M. Pakkal; B. Morgan; G. N Rutty
• Keywords: Adult; Aged, 80 and over; Male; Continuous Positive Airway Pressure; Angiography; Middle Aged; Sensitivity and Specificity; 3. Good health; Breath Holding; 03 medical and health sciences; 0302 clinical medicine; Postmortem Changes; Image Interpretation, Computer-Assisted; Humans; Female; Whole Body Imaging; Autopsy; Tomography, X-Ray Computed; Lung; Aged

Whilst the literature continues to report on advances in the use of post-mortem computed tomography (PMCT), particularly in relation to post-mortem angiography, there are few papers published that address the diagnostic problems related to post-mortem changes in the lungs and ventilation. We present a development of previous methods to achieve ventilated PMCT (VPMCT). We successfully introduced a supraglottic airway in 17/18 cases without causing overt damage, despite rigor mortis. Using a clinical portable ventilator, we delivered continuous positive airway pressure to mimic clinical breath-hold inspiratory scans. This caused significant lung expansion and a reduction in lung density and visible normal post-mortem changes. All thoracic pathology identified at autopsy, including pneumonia, was diagnosed on VPMCT in this small series. This technique provides a rapid form of VPMCT, which can be used in both permanent and temporary mortuaries, allowing for the post-mortem radiological comparison of pre-ventilation and post-ventilation images mimicking expiratory and inspiratory phases. We believe that it will enhance the diagnostic ability of PMCT in relation to lung pathology.