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Erschienen in: International Journal of Legal Medicine 6/2019

20.02.2019 | Original Article

Hounsfield unit values of liver pathologies in unenhanced post-mortem computed tomography

verfasst von: Carmen Tisch, Eva Brencicova, Nicole Schwendener, Paolo Lombardo, Christian Jackowski, Wolf-Dieter Zech

Erschienen in: International Journal of Legal Medicine | Ausgabe 6/2019

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Abstract

Background

The goal of this study was to evaluate if unenhanced PMCT HU values of liver pathologies differ from post-mortem HU values of non-pathologic liver tissue.

Methods

Liver HU values were measured in five liver segments in PMCT unenhanced datasets of 214 forensic cases (124 male, 90 female, mean age 54.3 years). Liver HU values were compared with corresponding histologic liver findings. HU values of non-pathologic livers were compared to HU values of liver pathologies.

Results

A total of 64 non-pathologic livers (mean HU 58.32, SD 8.91) were assessed. Histologic diagnosed liver pathologies were as follows: steatosis (n = 121 (grade I n = 61, grade II n = 37, grade III n = 23)), fibrosis (n = 10), and cirrhosis (n = 19). HU values of the livers exhibiting severe steatosis (mean HU 32.44, SD 13.76), fibrosis (mean HU 44.7, SD 16.31), and cirrhosis (mean HU 50.59, SD 9.42) significantly differed to HU values of non-pathologic livers at ANOVA testing.

Conclusion

PMCT unenhanced liver HU value measurements may be used as an additional method to detect unspecific liver-pathology. Values below 30 HU may specifically indicate severe steatosis.
Literatur
1.
Zurück zum Zitat Flach PM, Thali MJ, Germerott T (2014) Times have changed! Forensic radiology--a new challenge for radiology and forensic pathology. AJR Am J Roentgenol 202(4):W325–W334CrossRef Flach PM, Thali MJ, Germerott T (2014) Times have changed! Forensic radiology--a new challenge for radiology and forensic pathology. AJR Am J Roentgenol 202(4):W325–W334CrossRef
2.
Zurück zum Zitat Lundström C, Persson A, Ross S, Ljung P, Lindholm S, Gyllensvärd F, Ynnerman A (2012) State-of-the-art of visualization in post-mortem imaging. APMIS 120(4):316–326CrossRef Lundström C, Persson A, Ross S, Ljung P, Lindholm S, Gyllensvärd F, Ynnerman A (2012) State-of-the-art of visualization in post-mortem imaging. APMIS 120(4):316–326CrossRef
3.
Zurück zum Zitat Christe A, Flach P, Ross S, Spendlove D, Bolliger S, Vock P, Thali MJ (2010) Clinical radiology and postmortem imaging (Virtopsy) are not the same: specific and unspecific postmortem signs. Leg Med (Tokyo) 12(5):215–222CrossRef Christe A, Flach P, Ross S, Spendlove D, Bolliger S, Vock P, Thali MJ (2010) Clinical radiology and postmortem imaging (Virtopsy) are not the same: specific and unspecific postmortem signs. Leg Med (Tokyo) 12(5):215–222CrossRef
4.
Zurück zum Zitat Strandberg S, Wretling ML, Wredmark T, Shalabi A (2010) Reliability of computed tomography measurements in assessment of thigh muscle cross-sectional area and attenuation. BMC Med Imaging:10–18 Strandberg S, Wretling ML, Wredmark T, Shalabi A (2010) Reliability of computed tomography measurements in assessment of thigh muscle cross-sectional area and attenuation. BMC Med Imaging:10–18
5.
Zurück zum Zitat Pickhardt PJ, Park SH, Hahn L, Lee SG, Bae KT, Yu ES (2012) Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis. Eur Radiol 22(5):1075–1082CrossRef Pickhardt PJ, Park SH, Hahn L, Lee SG, Bae KT, Yu ES (2012) Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis. Eur Radiol 22(5):1075–1082CrossRef
6.
Zurück zum Zitat Ruder TD, Thali Y, Schindera ST, Dalla Torre SA, Zech WD, Thali MJ, Ross S, Hatch GM (2012) How reliable are Hounsfield-unit measurements in forensic radiology? Forensic Sci Int 220(1–3):219–223CrossRef Ruder TD, Thali Y, Schindera ST, Dalla Torre SA, Zech WD, Thali MJ, Ross S, Hatch GM (2012) How reliable are Hounsfield-unit measurements in forensic radiology? Forensic Sci Int 220(1–3):219–223CrossRef
7.
Zurück zum Zitat Klop AC, Vester MEM, Colman KL, Ruijter JM, Van Rijn RR, Oostra RJ (2017) The effect of repeated freeze-thaw cycles on human muscle tissue visualized by postmortem computed tomography (PMCT). Clin Anat 30(6):799–804CrossRef Klop AC, Vester MEM, Colman KL, Ruijter JM, Van Rijn RR, Oostra RJ (2017) The effect of repeated freeze-thaw cycles on human muscle tissue visualized by postmortem computed tomography (PMCT). Clin Anat 30(6):799–804CrossRef
8.
Zurück zum Zitat Schober D, Schwendener N, Zech WD, Jackowski C, Post-mortem CT (2017) Hounsfield unit profiles obtained in the lungs with respect to the cause of death assessment. Int J Legal Med 131(1):199–210CrossRef Schober D, Schwendener N, Zech WD, Jackowski C, Post-mortem CT (2017) Hounsfield unit profiles obtained in the lungs with respect to the cause of death assessment. Int J Legal Med 131(1):199–210CrossRef
9.
Zurück zum Zitat Zech WD, Jackowski C, Schwendener N, Brencicova E, Schuster F, Lombardo P (2016) Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings. Int J Legal Med 130(1):191–198CrossRef Zech WD, Jackowski C, Schwendener N, Brencicova E, Schuster F, Lombardo P (2016) Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings. Int J Legal Med 130(1):191–198CrossRef
10.
Zurück zum Zitat Zech WD, Jackowski C, Buetikofer Y, Kara L (2014) Characterization and differentiation of body fluids, putrefaction fluid, and blood using Hounsfield unit in postmortem CT. Int J Legal Med 128(5):795–802CrossRef Zech WD, Jackowski C, Buetikofer Y, Kara L (2014) Characterization and differentiation of body fluids, putrefaction fluid, and blood using Hounsfield unit in postmortem CT. Int J Legal Med 128(5):795–802CrossRef
11.
Zurück zum Zitat Huda W, Slone R (2003) Review of radiologic physics, 3rd edn. Lippincott Williams & Wilkins, Philadelphia Huda W, Slone R (2003) Review of radiologic physics, 3rd edn. Lippincott Williams & Wilkins, Philadelphia
12.
Zurück zum Zitat Allen BC, Barnhart H, Bashir M, Nieman C, Breault S, Jaffe TA (2012) Diagnostic accuracy of intra-abdominal fluid collection characterization in the era of multidetector computed tomography. Am Surg 78(2):185–189PubMed Allen BC, Barnhart H, Bashir M, Nieman C, Breault S, Jaffe TA (2012) Diagnostic accuracy of intra-abdominal fluid collection characterization in the era of multidetector computed tomography. Am Surg 78(2):185–189PubMed
13.
Zurück zum Zitat Bydder GM, Kreel L (1980) Attenuation values of fluid collections within the abdomen. J Comput Assist Tomogr 4(2):145–150CrossRef Bydder GM, Kreel L (1980) Attenuation values of fluid collections within the abdomen. J Comput Assist Tomogr 4(2):145–150CrossRef
14.
Zurück zum Zitat Churchill RJ (1989) CT of intra-abdominal fluid collections. Radiol Clin N Am 27(4):653–666PubMed Churchill RJ (1989) CT of intra-abdominal fluid collections. Radiol Clin N Am 27(4):653–666PubMed
15.
Zurück zum Zitat Kodama Y, Ng CS, Wu TT, Ayers GD, Curley SA, Abdalla EK, Vauthey JN, Charnsangavej C (2007) Comparison of CT methods for determining the fat content of the liver. Am J Roentgenol 188(5):1307–1312CrossRef Kodama Y, Ng CS, Wu TT, Ayers GD, Curley SA, Abdalla EK, Vauthey JN, Charnsangavej C (2007) Comparison of CT methods for determining the fat content of the liver. Am J Roentgenol 188(5):1307–1312CrossRef
16.
Zurück zum Zitat Hahn L, Reeder SB, Del Rio AM, Pickhardt PJ (2015) Longitudinal changes in liver fat content in asymptomatic adults: hepatic attenuation on unenhanced ct as an imaging biomarker for steatosis. Am J Roentgenol 205(6):1167–1172CrossRef Hahn L, Reeder SB, Del Rio AM, Pickhardt PJ (2015) Longitudinal changes in liver fat content in asymptomatic adults: hepatic attenuation on unenhanced ct as an imaging biomarker for steatosis. Am J Roentgenol 205(6):1167–1172CrossRef
17.
Zurück zum Zitat Zeb I, Li D, Nasir K, Katz R, Larijani VN, Budoff MJ (2012) Computed tomography scans in the evaluation of fatty liver disease in a population based study: the multi-ethnic study of atherosclerosis. Acad Radiol 19(7):811–818CrossRef Zeb I, Li D, Nasir K, Katz R, Larijani VN, Budoff MJ (2012) Computed tomography scans in the evaluation of fatty liver disease in a population based study: the multi-ethnic study of atherosclerosis. Acad Radiol 19(7):811–818CrossRef
18.
Zurück zum Zitat Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB (2006) Fatty liver: imaging patterns and pitfalls. Radiographics 26(6):1637–1653CrossRef Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB (2006) Fatty liver: imaging patterns and pitfalls. Radiographics 26(6):1637–1653CrossRef
19.
Zurück zum Zitat Boyce CJ, Pickhardt PJ, Kim DH, Taylor AJ, Winter TC, Bruce RJ, Lindstrom MJ, Hinshaw JL (2010) Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. Am J Roentgenol 194(3):623–628CrossRef Boyce CJ, Pickhardt PJ, Kim DH, Taylor AJ, Winter TC, Bruce RJ, Lindstrom MJ, Hinshaw JL (2010) Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. Am J Roentgenol 194(3):623–628CrossRef
20.
Zurück zum Zitat Brogdon BG (2010) Brogdon’s forensic radiology, 2nd edn. CRC Press, Boca Raton Brogdon BG (2010) Brogdon’s forensic radiology, 2nd edn. CRC Press, Boca Raton
21.
Zurück zum Zitat Egger C, Vaucher P, Doenz F, Palmiere C, Mangin P, Grabherr S (2012) Development and validation of a postmortem radiological alteration index: the RA-index. Int J Legal Med 126(4):559–566CrossRef Egger C, Vaucher P, Doenz F, Palmiere C, Mangin P, Grabherr S (2012) Development and validation of a postmortem radiological alteration index: the RA-index. Int J Legal Med 126(4):559–566CrossRef
22.
Zurück zum Zitat Recommendation no. R (99) 3 of the Committee of Ministers to member states on the harmonization of medico-legal autopsy rules (2000) Forensic Sci Int 111(1–3):5–58 Recommendation no. R (99) 3 of the Committee of Ministers to member states on the harmonization of medico-legal autopsy rules (2000) Forensic Sci Int 111(1–3):5–58
23.
Zurück zum Zitat Brunt EM (2005) Pathology of nonalcoholic steatohepatitis. Hepatol Res 33(2):68–71CrossRef Brunt EM (2005) Pathology of nonalcoholic steatohepatitis. Hepatol Res 33(2):68–71CrossRef
24.
Zurück zum Zitat Kumar V, Abbas AK, Aster JC (eds) (2015) Robbins & Cotran: pathologic basis of disease. 9th ed. Elsevier Saunders, Philadelphia Kumar V, Abbas AK, Aster JC (eds) (2015) Robbins & Cotran: pathologic basis of disease. 9th ed. Elsevier Saunders, Philadelphia
25.
Zurück zum Zitat Zeitoun D, Brancatelli G, Colombat M, Federle MP, Valla D, Wu T, Degott C, Vilgrain V (2004) Congenital hepatic fibrosis: CT findings in 18 adults. Radiology 231(1):109–116CrossRef Zeitoun D, Brancatelli G, Colombat M, Federle MP, Valla D, Wu T, Degott C, Vilgrain V (2004) Congenital hepatic fibrosis: CT findings in 18 adults. Radiology 231(1):109–116CrossRef
26.
Zurück zum Zitat Brancatelli G, Baron RL, Peterson MS, Marsh W (2003) Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation. AJR Am J Roentgenol 180(4):1007–1014CrossRef Brancatelli G, Baron RL, Peterson MS, Marsh W (2003) Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation. AJR Am J Roentgenol 180(4):1007–1014CrossRef
27.
Zurück zum Zitat Bott E, O'Donnell C, Burke M (2013) Post mortem CT demonstration of hemoperitoneum caused by rupture of a paraumbilical vein into a paraumbilical hernia in a man with liver cirrhosis and portal hypertension. Forensic Sci Med Pathol 9(1):77–81CrossRef Bott E, O'Donnell C, Burke M (2013) Post mortem CT demonstration of hemoperitoneum caused by rupture of a paraumbilical vein into a paraumbilical hernia in a man with liver cirrhosis and portal hypertension. Forensic Sci Med Pathol 9(1):77–81CrossRef
28.
Zurück zum Zitat Usui A, Kawasumi Y, Hosokai Y, Saito H, Igari Y, Funayama M (2013) Fatal intra-abdominal hemorrhage as a result of avulsion of the gallbladder: a postmortem case report. Acta Radiol Short Rep 2(2):2047981613482898PubMedPubMedCentral Usui A, Kawasumi Y, Hosokai Y, Saito H, Igari Y, Funayama M (2013) Fatal intra-abdominal hemorrhage as a result of avulsion of the gallbladder: a postmortem case report. Acta Radiol Short Rep 2(2):2047981613482898PubMedPubMedCentral
29.
Zurück zum Zitat Wells MM, Li Z, Addeman B, McKenzie CA, Mujoomdar A, Beaton M, Bird J (2016) Computed tomography measurement of hepatic steatosis: prevalence of hepatic steatosis in a Canadian population. Can J Gastroenterol Hepatol 2016:4930987CrossRef Wells MM, Li Z, Addeman B, McKenzie CA, Mujoomdar A, Beaton M, Bird J (2016) Computed tomography measurement of hepatic steatosis: prevalence of hepatic steatosis in a Canadian population. Can J Gastroenterol Hepatol 2016:4930987CrossRef
30.
Zurück zum Zitat Lawrence DA, Oliva IB, Israel GM (2012) Detection of hepatic steatosis on contrast-enhanced CT images: diagnostic accuracy of identification of areas of presumed focal fatty sparing. AJR Am J Roentgenol 199(1):44–47CrossRef Lawrence DA, Oliva IB, Israel GM (2012) Detection of hepatic steatosis on contrast-enhanced CT images: diagnostic accuracy of identification of areas of presumed focal fatty sparing. AJR Am J Roentgenol 199(1):44–47CrossRef
31.
Zurück zum Zitat Yokota H, Yamamoto S, Horikoshi T, Shimofusa R, Ito H (2009) What is the origin of intravascular gas on postmortem computed tomography? Leg Med (Tokyo) 11(Suppl 1):S252–S255CrossRef Yokota H, Yamamoto S, Horikoshi T, Shimofusa R, Ito H (2009) What is the origin of intravascular gas on postmortem computed tomography? Leg Med (Tokyo) 11(Suppl 1):S252–S255CrossRef
32.
Zurück zum Zitat Jackowski C, Sonnenschein M, Thali MJ, Aghayev E, Yen K, Dirnhofer R, Vock P (2007) Intrahepatic gas at postmortem computed tomography: forensic experience as a potential guide for in vivo trauma imaging. J Trauma 62(4):979–988CrossRef Jackowski C, Sonnenschein M, Thali MJ, Aghayev E, Yen K, Dirnhofer R, Vock P (2007) Intrahepatic gas at postmortem computed tomography: forensic experience as a potential guide for in vivo trauma imaging. J Trauma 62(4):979–988CrossRef
33.
Zurück zum Zitat Gebhart FT, Brogdon BG, Zech WD, Thali MJ, Germerott T (2012) Gas at postmortem computed tomography--an evaluation of 73 non-putrefied trauma and non-trauma cases. Forensic Sci Int 222(1–3):162–169CrossRef Gebhart FT, Brogdon BG, Zech WD, Thali MJ, Germerott T (2012) Gas at postmortem computed tomography--an evaluation of 73 non-putrefied trauma and non-trauma cases. Forensic Sci Int 222(1–3):162–169CrossRef
34.
Zurück zum Zitat Schmitt WG (1986) Energy dependence of Hounsfield numbers. Röfo 145(2):221–223PubMed Schmitt WG (1986) Energy dependence of Hounsfield numbers. Röfo 145(2):221–223PubMed
35.
Zurück zum Zitat Bydder GM, Kreel L (1979) The temperature dependence of computed tomography attenuation values. J Comput Assist Tomogr 3(4):506–510CrossRef Bydder GM, Kreel L (1979) The temperature dependence of computed tomography attenuation values. J Comput Assist Tomogr 3(4):506–510CrossRef
Metadaten
Titel
Hounsfield unit values of liver pathologies in unenhanced post-mortem computed tomography
verfasst von
Carmen Tisch
Eva Brencicova
Nicole Schwendener
Paolo Lombardo
Christian Jackowski
Wolf-Dieter Zech
Publikationsdatum
20.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Legal Medicine / Ausgabe 6/2019
Print ISSN: 0937-9827
Elektronische ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-019-02016-1

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