AI Article Synopsis
- Ventilated postmortem computed tomography (vPMCT) enhances lung imaging in children compared to standard postmortem CT (PMCT), allowing for better evaluation of lung conditions.
- A study of 12 children showed that ventilated PMCT produced diagnostic-quality lung images in all cases, dramatically improving image quality compared to unventilated PMCT.
- The use of laryngeal mask airway with continuous positive pressure provided the best imaging results, indicating that vPMCT may improve the accuracy of imaging-assisted autopsies in pediatric patients.
Article Abstract
Objectives: Ventilated postmortem computed tomography (vPMCT) is associated with improved pulmonary imaging compared to standard PMCT in adults. We aimed to evaluate the feasibility of performing ventilated PMCT in children.
Methods: Postmortem thoracic CT was performed before (PMCT) and after ventilation (vPMCT). We used a range of mouthpieces, including endotracheal tubes, bag and mask and laryngeal mask airway (LMA). Hounsfield units of the lungs at PMCT were measured for normal and abnormal lung areas, before and after ventilation. All patients underwent full conventional autopsy and histology.
Results: Twelve patients underwent ventilated PMCT, median age 52 days (range 3-304 days). Ventilated PMCT provided diagnostic lung images in all 12 cases, compared to only three unventilated PMCT examinations (p < 0.005). In all cases, ventilated PMCT improved the image quality of aerated lungs irrespective of the method used. Average lung Hounsfield units decreased significantly with ventilation from pre-vPMCT values (-134.1 ± 215.1 vs post-vPMCT -531.8 ± 190.1; p < 0.001). LMA with continuous positive pressure ventilation subjectively provided the best results.
Conclusion: Ventilated PMCT significantly improves lung aeration in children and can aid recognition of areas of abnormality in paediatric lungs. Such advances will improve accuracy and uptake of imaging-assisted autopsies in children.
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