title: Hypothermic death: possibility of diagnosis by post-mortem computed tomography.
abstract: Referring to our experience with post-mortem computed tomography (CT), many hypothermic death cases presented a lack of increase in lung-field concentration, blood clotting in the heart, thoracic aorta or pulmonary artery, and urine retention in the bladder. Thus we evaluated the diagnostic performance of post-mortem CT on hypothermic death based on the above-mentioned three findings. Twenty-four hypothermic death subjects and 53 non-hypothermic death subjects were examined. Two radiologists assessed the presence or lack of an increase in lung-field concentration, blood clotting in the heart, thoracic aorta or pulmonary artery, and measured urine volume in the bladder. Pearson's chi-square test and Mann-Whitney U-test were used to assess the relationship between the three findings and hypothermic death. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the diagnosis were also calculated. Lack of an increase in lung-field concentration and blood clotting in the heart, thoracic aorta or pulmonary artery were significantly associated with hypothermic death (p=0.0007, p<0.0001, respectively). The hypothermic death cases had significantly more urine in the bladder than the non-hypothermic death cases (p=0.0011). Regarding the diagnostic performance with all three findings, the sensitivity was 29.2% but the specificity was 100%. These three findings were more common in hypothermic death cases. Although the sensitivity was low, these findings will assist forensic physicians in diagnosing hypothermic death since the specificity was high.
authors.affiliation: Tohoku University Graduate School of Medicine, Department of Clinical Imaging, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. ssu@rad.med.tohoku.ac.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kawasumi
authors.forename: Naoki
authors.initials: N
authors.lastname: Onozuka
authors.forename: Ayana
authors.initials: A
authors.lastname: Kakizaki
authors.forename: Akihito
authors.initials: A
authors.lastname: Usui
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Hosokai
authors.forename: Miho
authors.initials: M
authors.lastname: Sato
authors.forename: Haruo
authors.initials: H
authors.lastname: Saito
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ishibashi
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Hayashizaki
authors.forename: Masato
authors.initials: M
authors.lastname: Funayama
mesh_terms: D001344:Autopsy / Q000379:methods* / Q000706:statistics & numerical data*; D002423:Cause of Death; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology* / Q000401:mortality*; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*