Noninvasive postmortem investigation of cases refusing autopsy using computed tomography


  • Jitladda Wasinrat, M.D. Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
  • Pakorn Wasinrat, M.D.



Postmortem CT, Cause of death, Refusing autopsy case, Virtual autopsy


Background: CT is a well-known tool to assess several conditions in living patients. The post-mortem CT (PMCT) has been introduced to determine the cause of death in dead subjects. CT is also the imaging modality of choice for the analysis of autopsy findings including fracture, hematoma, gas collection and gross tumor injury. The rate of standard autopsy is continuing to decline and there are several reasons for refusing autopsy.

Objective: The current research endeavor is investigate the usefulness of computed tomography (CT) in cases refusing autopsy.

Materials and Methods: In this study, the PMCT were evaluated in 150 subjects in different contexts of death. The causes of death were classified into four categories which include a definite cause of death, a possible cause of death, a minor pathological finding and no fatal findings. For the definite cause of death and the possible cause of death, the specific lesions are described in detail.

Results: The definite cause of death was detected in 48 (32%) of the subjects. The possible cause of death was detected in 18 (12%) of the subjects. The remaining 84 subjects were classified into minor pathological findings and no fatal findings in 46 (30.7%) and 38 (25.3%) of the patients, respectively. The fatal lesions of PMCT were found in 93 lesions(48 subjects) that were demonstrated by anatomical locations into the traumatic bone, intracranial, spine, thoracic, heart leak and abdominal lesions. We found definite causes of death in 6 subjects, which had no history of trauma and malignancy and were mentioned about a cardiopulmonary failure as a cause of death at first.

Conclusion: The PMCT is a useful tool for identifying the cause of death in many cases that have limitations for conventional autopsy. The morphological change such as intracranial hemorrhage is easily diagnosed with PMCT. The PMCT appears to be an alternative tool to assess the cause of death in any reason of objections. 


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How to Cite

Wasinrat J, Wasinrat P. Noninvasive postmortem investigation of cases refusing autopsy using computed tomography . ASEAN J Radiol [Internet]. 2023 Dec. 31 [cited 2024 Jun. 13];24(3):246-58. Available from:



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