Brain Swelling and Loss of Gray and White Matter Differentiation in Human Postmortem Cases by Computed Tomography

Go Shirota; Wataru Gonoi; Masanori Ishida; Hidemi Okuma; Yukako Shintani; Hiroyuki Abe; Yutaka Takazawa; Masako Ikemura; Masashi Fukayama; Kuni Ohtomo

doi:10.1371/journal.pone.0143848

Brain Swelling and Loss of Gray and White Matter Differentiation in Human Postmortem Cases by Computed Tomography

PLoS One. 2015 Nov 30;10(11):e0143848. doi: 10.1371/journal.pone.0143848. eCollection 2015.

Authors

Affiliations

¹ Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
² Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, 2-5 Kandasurugadai, Chiyoda-ku, Tokyo 101-8326, Japan.
³ Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Abstract

The purpose of this study was to evaluate the brain by postmortem computed tomography (PMCT) versus antemortem computed tomography (AMCT) using brains from the same patients. We studied 36 nontraumatic subjects who underwent AMCT, PMCT, and pathological autopsy in our hospital between April 2009 and December 2013. PMCT was performed within 20 h after death, followed by pathological autopsy including the brain. Autopsy confirmed the absence of intracranial disorders that might be related to the cause of death or might affect measurements in our study. Width of the third ventricle, width of the central sulcus, and attenuation in gray matter (GM) and white matter (WM) from the same area of the basal ganglia, centrum semiovale, and high convexity were statistically compared between AMCT and PMCT. Both the width of the third ventricle and the central sulcus were significantly shorter in PMCT than in AMCT (P < 0.0001). GM attenuation increased after death at the level of the centrum semiovale and high convexity, but the differences were not statistically significant considering the differences in attenuation among the different computed tomography scanners. WM attenuation significantly increased after death at all levels (P<0.0001). The differences were larger than the differences in scanners. GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001). PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Autopsy
Brain Edema / diagnostic imaging*
Brain Edema / pathology*
Female
Humans
Male
Middle Aged
Phantoms, Imaging
Postmortem Changes
Tomography Scanners, X-Ray Computed / statistics & numerical data
Tomography, X-Ray Computed / instrumentation
Tomography, X-Ray Computed / methods*
White Matter / diagnostic imaging*
White Matter / pathology*

Grants and funding

This work was supported by a grant from the Japanese Ministry of Health, Labor and Welfare, for research into “Usefulness of Postmortem Images as an Ancillary Method for Autopsy in Evaluation of Death Associated with Medical Practice (2008–2009)”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.