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Multidetector Computed Tomography Findings in Deaths With Severe Burns

Levy, Angela D. MD*; Harcke, Howard T. MD*†; Getz, John M. BS; Mallak, Craig T. MD

The American Journal of Forensic Medicine and Pathology: June 2009 - Volume 30 - Issue 2 - p 137-141
doi: 10.1097/PAF.0b013e3181879cc9
Original Article

This study compared autopsy with postmortem multidetector computed tomography (MDCT) findings in charred remains. Seventeen consecutive male subjects (mean age, 29.4 years) who perished in a fire-related event resulting in charred remains underwent total body MDCT immediately prior to routine autopsy that included serum carboxyhemoglobin measurement. MDCT showed all thermal tissue changes (skin and subcutaneous fat loss, skeletal muscle retraction, pugilistic attitude, cortical fractures, bone and organ destruction, thermal epidural hematoma, and thermal amputation) and established all fracture patterns that were lethal, but autopsy added the fire as a contributory cause of death when there was carboxyhemoglobin elevation. MDCT had limited value in determination of lethal vascular and visceral injuries. MDCT is an effective complement to autopsy in the setting of charred remains and may serve to augment a limited autopsy. This may be particularly useful in mass casualty scenarios.

From the *Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD; †Department of Radiologic Pathology, Armed Forces Institute of Pathology, NW Washington, DC; and ‡The Office of the Armed Forces Medical Examiner, Armed Forces Institute of Pathology, Rockville, MD.

Manuscript received June 14, 2007; accepted September 14, 2007.

Supported by the Defense Advanced Research Projects Agency.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the view of the Department of the Army, Navy, or Defense.

Reprints: Angela D. Levy, MD, Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.