Skip to main content

17.02.2016 | Original Article | Ausgabe 5/2016

International Journal of Legal Medicine 5/2016

The cardiothoracic ratio on post-mortem computer tomography

International Journal of Legal Medicine > Ausgabe 5/2016
M. Jotterand, F. Doenz, S. Grabherr, M. Faouzi, S. Boone, P. Mangin, K. Michaud


In clinical practice, the cardiothoracic ratio (CTR) was first utilized on plain chest radiography, and subsequently with computed tomography (CT) to diagnose cardiomegaly with a threshold of 0.5. Using CTR in forensic practice could help to detect cardiomegaly on post-mortem CT (PMCT) prior to the autopsy. However, an adaption of the threshold could be necessary because of post-mortem changes. Our retrospective study aimed to measure the CTR on PMCT and test the possible influence of variables. We selected 109 autopsy cases in which the heart weight was within normal limits. A forensic pathologist and a radiologist measured separately the CTR on axial and scout views on PMCT. We tested the statistical concordance between the two readers and between the axial and scout view and identified factors that could be associated with a modification of the CTR. The CTR measurements revealed an overestimation of the measurements made on scout compared to axial view. The inter-reader correlation was very high for both views. Among the different variables statistically tested, heart dilatation and body mass index (BMI) were the only two factors statistically associated with an augmentation of the CTR. The CTR can be useful in the diagnosis of cardiomegaly on PMCT. However, dilatation of the cardiac chambers caused by acute heart failure may be misinterpreted radiographically as cardiomegaly. Inter-observer reliability in our study was very high. CTR may be overestimated when measured on the scout view. Further investigations with larger cohorts, including cases with cardiac hypertrophy, are necessary to better understand the relationship between radiological CTR and the morphology of the heart.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Über diesen Artikel

Weitere Artikel der Ausgabe 5/2016

International Journal of Legal Medicine 5/2016 Zur Ausgabe

Neu im Fachgebiet Rechtsmedizin

14.04.2021 | Schwerpunkt: Neue WHO-Klassifikationen und Digitales Lernen | Ausgabe 3/2021

Digitale Lehre im Fach Pathologie

06.04.2021 | Schwerpunkt: Neue WHO-Klassifikationen und Digitales Lernen | Ausgabe 3/2021

Histologische Subtypen des Nierenzellkarzinoms

Übersicht und neue Entwicklungen

06.04.2021 | Sarkome | Schwerpunkt: Neue WHO-Klassifikationen und Digitales Lernen | Ausgabe 3/2021

Neues in der aktuellen WHO-Klassifikation (2020) für Weichgewebssarkome