Comparison of attenuation of striated muscle between postmortem and antemortem computed tomography: results of a longitudinal study

PLoS One. 2014 Nov 3;9(11):e111457. doi: 10.1371/journal.pone.0111457. eCollection 2014.


Objective: We evaluated the postmortem changes of striated muscle by comparing computed tomography (CT) images obtained postmortem and antemortem in the same patients.

Materials and methods: We studied 33 consecutive patients who underwent antemortem CT, postmortem CT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. Postmortem CT was performed within 20 h after death and was followed by pathological autopsy. Pathological autopsy confirmed the absence of muscular diseases such as amyotrophic lateral sclerosis, muscular dystrophy, myositis, and myasthenia, in all of the patients. The CT attenuation values of four cardiac muscle sites (anterior wall of the left ventricle, left ventricular free wall, posterior wall of the left ventricle, and the ventricular septum) and two skeletal muscle sites (the pectoralis major muscle and the erector spinae muscle) were compared between antemortem and postmortem CT using paired t test.

Results: Striated muscle had significantly greater attenuation on postmortem CT than on antemortem CT (P<0.001) in all six tissue sites. No significant association was found between postmortem change in the CT attenuation of striated muscle and gender, age, or elapsed time since death.

Conclusion: This is the first longitudinal study to show hyperattenuation of striated muscle on postmortem CT images compared with antemortem CT images in the same patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Autopsy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / pathology
  • Muscle, Striated / diagnostic imaging*
  • Muscle, Striated / pathology*
  • Myocardium / pathology
  • Postmortem Changes
  • Tomography, X-Ray Computed*
  • Young Adult

Grant support

This work was supported by a grant from the Japanese Ministry of Health, Labor and Welfare, for research into “Usefulness of Postmortem Images as an Ancillary Method for Autopsy in Evaluation of Death Associated with Medical Practice (2008–2009)”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.