title: Interobserver agreement of the injury diagnoses obtained by postmortem computed tomography of traffic fatality victims and a comparison with autopsy results.
abstract: The present study investigated the interobserver variation between a radiologist and a forensic pathologist in 994 injury diagnoses obtained by postmortem computed tomography (CT) of 67 traffic fatality victims, and the results were compared with diagnoses obtained by autopsy. The injuries were coded according to the abbreviated injury scale (AIS). We found a low interobserver variability for postmortem CT injury diagnoses, and the variability was the lowest for injuries with a high AIS severity score. The radiologist diagnosed more injuries than the pathologist, especially in the skeletal system, but the pathologist diagnosed more organ injuries. We recommend the use of a radiologist as a consultant for the evaluation of postmortem CT images. Training in radiology should be included in forensic medicine postgraduate training. CT was superior to autopsy in detecting abnormal air accumulations, but autopsy was superior to CT in the detection of organ injuries and aortic ruptures. We recommend a combination of CT and autopsy for the postmortem investigation of traffic fatality victims.
authors.affiliation: Institute of Forensic Medicine, University of Southern Denmark, Odense, Denmark. pleth@health.sdu.dk
authors.forename: Peter Mygind
authors.initials: PM
authors.lastname: Leth
authors.forename: Henrik
authors.initials: H
authors.lastname: Struckmann
authors.forename: Jens
authors.initials: J
authors.lastname: Lauritsen
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000473:pathology; D001344:Autopsy; D049429:Forensic Pathology; D006801:Humans; D015588:Observer Variation; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000000981:diagnostic imaging* / Q000473:pathology*