title: Whole-body post-mortem computed tomography compared with autopsy in the investigation of unexpected death in infants and children.
abstract: OBJECTIVE
  To investigate the contribution of whole-body post-mortem computed tomography (PMCT) in sudden unexpected death in infants and children.
  
  
  METHODS
  Forty-seven cases of sudden unexpected death in children investigated with radiographic skeletal survey, whole-body PMCT and autopsy were enrolled. For imaging interpretation, non-specific post-mortem modifications and abnormal findings related to the presumed cause of death were considered separately. All findings were correlated with autopsy findings.
  
  
  RESULTS
  There were 31 boys and 16 girls. Of these, 44 children (93.6 %) were younger than 2 years. The cause of death was found at autopsy in 18 cases (38.3 %), with 4 confirmed as child abuse, 12 as infectious diseases, 1 as metabolic disease and 1 as bowel volvulus. PMCT results were in accordance with autopsy in all but three of these 18 cases. Death remains unexplained in 29 cases (61.7 %) and was correlated with no abnormal findings on PMCT in 27 cases. Major discrepancies between PMCT and autopsy findings concerned pulmonary analysis.
  
  
  CONCLUSIONS
  Whole-body PMCT may detect relevant findings that can help to explain sudden unexpected death and is essential for detecting non-accidental injuries. We found broad concordance between autopsy and PMCT, except in a few cases of pneumonia. It is a non-invasive technique acceptable to relatives.
  
  
  CONCLUSIONS
  • Whole-body post-mortem computed tomography (PMCT) is an effective non-invasive method. • Whole-body PMCT is essential for detecting child abuse in unexpected death. • There is concordance on cause of death between PMCT and autopsy. • Whole-body PMCT could improve autopsy through dissection and sampling guidance. • PMCT shows findings that may be relevant when parents reject autopsy.
authors.affiliation: Department of Radiology, Rennes University Hospital, CHU Hôpital Sud, Boulevard de Bulgarie, BP 90347, 35203 Rennes Cedex 2, France. maia-proisy@orange.fr
authors.forename: Maïa
authors.initials: M
authors.lastname: Proisy
authors.forename: Antoine Jérôme
authors.initials: AJ
authors.lastname: Marchand
authors.forename: Philippe
authors.initials: P
authors.lastname: Loget
authors.forename: Renaud
authors.initials: R
authors.lastname: Bouvet
authors.forename: Michel
authors.initials: M
authors.lastname: Roussey
authors.forename: Fabienne
authors.initials: F
authors.lastname: Pelé
authors.forename: Céline
authors.initials: C
authors.lastname: Rozel
authors.forename: Catherine
authors.initials: C
authors.lastname: Treguier
authors.forename: Pierre
authors.initials: P
authors.lastname: Darnault
authors.forename: Bertrand
authors.initials: B
authors.lastname: Bruneau
mesh_terms: D001344:Autopsy; D002423:Cause of Death; D002648:Child; D002649:Child Abuse; D002675:Child, Preschool; D003645:Death, Sudden / Q000209:etiology*; D005260:Female; D006257:Head / Q000473:pathology; D006801:Humans; D007223:Infant; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods