Effects of blood loss on organ attenuation on postmortem CT and organ weight at autopsy

Jakob Heimer; Vasiliki Chatzaraki; Wolf Schweitzer; Michael J Thali; Thomas D Ruder

doi:10.1007/s00414-021-02731-8

Effects of blood loss on organ attenuation on postmortem CT and organ weight at autopsy

Int J Legal Med. 2022 Mar;136(2):649-656. doi: 10.1007/s00414-021-02731-8. Epub 2021 Nov 24.

Authors

Jakob Heimer¹, Vasiliki Chatzaraki², Wolf Schweitzer², Michael J Thali², Thomas D Ruder³

Affiliations

¹ Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland. Jakob.Heimer@irm.uzh.ch.
² Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
³ Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 , Bern, Switzerland.

Abstract

Background: Cases of external hemorrhage are difficult to recognize on postmortem computed tomography (PMCT).

Purpose: To investigate the effects of blood loss on CT attenuation of the spleen, liver, kidneys, and lungs on PMCT and to assess the relationship between blood loss and organ weight.

Methods: A total of 125 cases with blood loss were sex- and age-matched to 125 control cases without blood loss. Individual organ attenuation was measured on transverse CT images. Organ weights of the liver, spleen, kidneys, and lung were extracted from the autopsy protocols.

Results: Organ weight was significantly lower in cases with blood loss (lung 30%, spleen 28%, kidneys 14%, liver 18%) than in controls. CT attenuation of the lungs was significantly lower (30%) in cases with blood loss than in controls. CT attenuation of the spleen and kidneys did not significantly differ between cases and controls. CT attenuation of the liver was significantly higher (25%) in cases with blood loss than in controls.

Conclusion: Blood loss decreases organ weight and CT attenuation of the lungs but appears to have no significant effect on CT attenuation of the spleen and kidneys. The increased liver attenuation in cases with blood loss compared to controls was an unexpected finding and remains challenging to explain. One probable interpretation refers to different levels of hepatic glycogen; however, further work is warranted to substantiate this hypothesis.

Keywords: Autopsy; Exsanguination; Organ attenuation; Organ weight; Postmortem computed tomography.

MeSH terms

Autopsy
Hemorrhage / diagnostic imaging
Humans
Organ Size
Spleen* / diagnostic imaging
Tomography, X-Ray Computed* / methods