title: Rib fractures at postmortem computed tomography (PMCT) validated against the autopsy.
abstract: To evaluate the sensitivity of postmortem computed tomography (PMCT) in rib fracture detection validated against autopsy. Fifty-one forensic cases underwent a postmortem CT prior to forensic autopsy. Two image readers (radiologist and forensic pathologist) assessed high resolution CT data sets for rib fractures. Correct recognition rates (CRR), sensitivity and specificity values were calculated over all observations as well as individually for every rib and region. Additionally, for partial rib fractures the sensitivity of autopsy was calculated vice versa. 3876 entries in each study protocol (autopsy, PMCT radiologist and PMCT forensic pathologist) were investigated. A total of 690 fractures (autopsy), 491 (PMCT and radiologist) and 559 (PMCT and forensic pathologist) were detected. The CRR was 0.85. Sensitivity and specificity of PMCT for rib fracture detection were 0.63 (0.58 radiologist, 0.68 forensic pathologist) and 0.97 (both readers 0.97), respectively. Low CRR and sensitivity values were obtained for antero-lateral fractures. Partial rib fractures were better detected by PMCT. PMCT has a rather low sensitivity for rib fracture detection when validated against autopsy and indicates that clinical CT may also demonstrate a reasonable number of false negatives. Partial rib fractures often remain undetected at autopsy.
authors: Institute of Forensic Medicine, University of Zürich, Winterthurerstrasse 190/52, CH-8057 Zürich, Switzerland.
authors: Claudia
authors: C
authors: Schulze
authors: Hanno
authors: H
authors: Hoppe
authors: Wolf
authors: W
authors: Schweitzer
authors: Nicole
authors: N
authors: Schwendener
authors: Silke
authors: S
authors: Grabherr
authors: Christian
authors: C
authors: Jackowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015588:Observer Variation; D012253:Rib Fractures / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Forensic radiology; Postmortem CT; Rib fracture