Post-Mortem CT More Accurate Than MRI for Cause of Death

Common imaging errors in ischemic heart disease, lung embolism, pneumonia, intra-abdominal lesions

TUESDAY, Nov. 22 (HealthDay News) -- Post-mortem computed tomography (CT) is more accurate than magnetic resonance imaging (MRI) for providing a cause of death, according to a study published online Nov. 22 in The Lancet.

Ian S.D. Roberts, M.D., from John Radcliffe Hospital in Oxford, U.K., and colleagues investigated the accuracy of post-mortem CT and MRI, compared with full autopsy. A series of 182 adult deaths reported between April 2006 and November 2008 were investigated using whole-body CT and MRI, followed by full autopsy. Independent reporting of CT and MRI scans was done by two radiologists each, who subsequently produced a consensus report based on the techniques, recorded their confidence in the cause of death, and identified whether an autopsy was required.

The investigators found that the cause of death identified by radiology and autopsy showed a major discrepancy rate of 32, 43, and 30 percent for CT, MRI, and the consensus radiology report, respectively. The discrepancy rate was 10 percent lower for CT than MRI. Based on radiologist indications, autopsy was not required in 34, 42, and 48 percent of cases for CT, MRI, and consensus reports, respectively. Of these, there was a significantly lower major discrepancy rate, compared with autopsy, than in cases with no definite cause of death (16, 21, and 16 percent of CT, MRI, and consensus reports, respectively). Ischemic heart disease, pulmonary embolism, pneumonia, and intra-abdominal lesions were the most common imaging errors observed in identification of the cause of death.

"Compared with traditional autopsy, CT was a more accurate imaging technique than MRI for providing a cause of death," the authors write.

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