1.Decoding death by unknown causes using postmortem image-guided virtopsy: A review of recent literature and the Malaysian experience
Tawfiq Yousef Tawfiq Zyoud ; Saiful Nizam Abdul Rashid ; Subapriya Suppiah ; Ezamin Abdul Rahim ; Rozi Mahmud
The Medical Journal of Malaysia 2020;75(4):411-418
Introduction: Autopsy is one of the most important approaches
to identify clearly the exact cause of death, whether it was due
to natural causes, sudden death, or traumatic. Various studies
have been done in different countries regarding ways to
improve the diagnosis during autopsy. The imaging approach
is one of the methods that has been used to complement
autopsy findings and to enhance the diagnosis for achieving the
most accurate post-mortem diagnosis. The aim of this study is
to identify the role of imaging modalities that complement
routine autopsy and correlate the findings of diagnostic
imaging that can help improve the accuracy of diagnosing the
cause of death.
Methods: We sourced articles from Scopus, Ovid and PubMed
databases for journal publications related to post-mortem
diagnostic imaging. We highlight the most relevant full articles
in English that explain the type of modality that was utilised
and the added value it provided for diagnosing the cause of
death.
Results: Minimally invasive autopsies assisted by imaging
modalities added a great benefit to forensic medicine, and
supported conventional autopsy. In particular the role of post
mortem computed tomography (PMCT), post mortem
computed tomography angiography (PMMR) and positron
emission tomography computed tomography (PMCTA) that
have incremental benefits in diagnosing traumatic death,
fractures, tissue injuries, as well as the assessment of body
height or weight for corpse identification.
Conclusion: PMCT and PMMR, with particular emphasis on
PMCTA, can provide higher accuracy than the other
modalities. They can be regarded as indispensable methods
that should be applied to the routine autopsy protocol, thus
improving the findings and accuracy of diagnosing the cause of
death.