15283-B-Blokker

142 Chapter 8 RESULTS We scanned 100 cases from January 2012 to December 2014. The mean age was 62.7 (±13.0), 62% were male (Table 6). Inter-observer agreement was very good, with a kappa of 0.84 for PMCT and 0.83 for PMMR. The kappa score for the group with pathological mimics was 0.79 for PMCT and 0.76 for PMMR, the kappa score for the non-pathologic mimics was 0.89 for PMCT and 0.88 for PMMR. Total-body CT and MR features of postmortem change – general overview PMCT and PMMR features of different organs and observed frequencies are presented in Table 7-9. Brain Sedimentation led to increased attenuation of the posterior sagittal sinus (96%), cerebral veins (54%) andcerebral arteries (35%) inasymmetricdistribution (Fig1A-B). Putrefactive gasinthebrainwasseeninonlyafewcases(8%).Liquefactionofthebrainwasnotobserved. PMMR showed high T1 signal of the basal ganglia in one third of cases (Fig 1C). Effacement of sulci (Fig 1D) and loss of grey-white matter differentiation was seen in the majority of cases (85%) (Fig 1E-1F). Heart and large vessels The right atrium and ventricle were dilated in 25% (Fig 2A). The thoracic aorta showed clotting in 38% of cases and was detected best on PMMR (Fig 2B). Air in the heart chambers was seen in 44% (Fig 2C-D). No air was observed within the myocardium. T2 signal decline in the myocardium from the epicardial to endocardial regions was seen in 12% (Fig 2A).We observed a collapse of the thoracic aorta in 30% (Fig 2E). Sedimentation of blood was often present in the heart (84%) (Fig 2A) and large thoracic vessels (Fig 2F). The thoracic aortic wall showed increased attenuation in a majority of cases (90%) (Fig 2G). The abdominal aorta was collapsed in 67% and the abdominal vena cava in 53% (Fig 2H). Air in the vertebral venous plexus was seen less frequently (11%), and usually in cases with extensive intravascular air. Lungs Livor mortis affected the lungs frequently (86%); it appeared as areas with increased density or high T2 signal in the dependent areas of the lungs. In these parts of the lung it is challenging to distinguish livores from pneumonia (Fig 3A-I) or other interstitial diseases. Liquid in the trachea and bronchi was very common (78%). Pleural effusion was seen in only 38% of cases.