Abstract
Purpose: The aim of this study was to investigate the diagnostic ability of postmortem computed tomography（CT）in cases with traffic accident-related injuries. Methods: We examined postmortem CT in 51 subjects （male 33, female 18; mean age 57.4 years） who were brought to our institution after traffic accidents and died in our emergency department. These included 20 pedestrians, 12 cyclists or motorcyclists, and 19 automobile drivers or passengers. The examinations were performed with 16-row （n=29） or 64-row （n=22） detector CT scanners. All injuries detected by postmortem CT were coded using the Abbreviated Injury Scale （AIS）． Injury Severity Score （ISS） was calculated according to the AIS. Traditional autopsies were not performed. Results: Bone fractures, massive hemorrhage; e.g. hemothorax, hemoperitoneum, and retroperitonum hemorrhage, and gas density; e.g. pneumothorax and pneumocephalus were obviously recognized on postmortem CT. A total of 237 injuries （AIS 1: 5, AIS 2: 52, AIS 3: 78, AIS 4: 37, AIS 5: 43, and AIS 6: 22） were identified. All cases had AIS 3 or higher injuries （most severe injury, AIS 3: 3 cases, AIS 4: 7 cases, AIS 5: 21 cases, and AIS 6: 20 cases）． Calculated ISS ranged from 13 to 75 in pedestrians, from 13 to 75 in cyclists or motorcyclists, and from 25 to 75 in drivers and passengers. Postmortem CT revealed 68 injuries including 64 AIS 3 or higher injuries in head and neck, and 80 injuries including 65 AIS 3 or higher injuries in thorax, respectively. Injuries in the multiple regions were presented in 44 cases. Forty cases had AIS 3 or higher injuries in more than one region. Conslusions: Postmortem CT can detect fatal injuries, such as gross damages within viscera, bone fractures, massive hemorrhage, or pneumothorax. Postmortem CT is useful to evaluate the injuries in traffic accident victims.
