{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:14:28Z","timestamp":1783322068815,"version":"3.54.6"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bern"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In forensic autopsies, the terminal circulatory status in the form of acute congestion or findings consistent with severe blood loss can be significant, as it may indicate different causes of death. However, the autopsy-related description of acute congestion or severe blood loss is predominantly subjective. Post-mortem computed tomography (PMCT) offers the possibility of recording metric parameters such as the cross-sectional area of blood vessels, which could be used for the objective description of acute congestion or severe blood loss. The aim of the present study was therefore to record and compare the cross-sectional areas of smaller and larger blood vessels for different causes of death in forensic PMCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009500 forensic autopsy cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009250 men and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009250 women), the cross-sectional area of various blood vessels near the heart (internal jugular veins, subclavian veins, pulmonary trunk, ascending aorta, descending thoracic aorta, superior vena cava, and inferior vena cava) was measured using PMCT. The cross-sectional area measurements were compared for different causes of death (acute cardiac arrest due to underlying myocardial disease, pulmonary embolism, pneumonia, hypothermia, central dysregulation due to head trauma, suffocation, strangulation, drowning, fatal hemorrhage, and intoxication) in each vessel examined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For all causes of death combined, significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) between men and women were found for each individual vessel. In each vessel examined, the lowest mean cross-sectional area measurements were observed in fatal hemorrhage (HE), and the highest mean cross-sectional area measurements were observed in pulmonary embolism (PE) and acute cardiac arrest (CA) in both sexes. The PE and CA groups, as well the HE groups, differed significantly from all other causes of death in both men and women.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PMCT cross-sectional area measurements of larger and smaller blood vessels near the heart can be used to objectively describe the terminal circulatory status in cases of pronounced acute blood congestion or fatal hemorrhage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00414-026-03865-3","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:24:30Z","timestamp":1783319070000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-sectional blood vessel area differences in various causes of death in unenhanced forensic post-mortem computed tomography"],"prefix":"10.1007","author":[{"given":"Cynthia","family":"Ruedin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"Fridle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conny","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-4891","authenticated-orcid":false,"given":"Wolf-Dieter","family":"Zech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"3865_CR1","unstructured":"Madea B (2022) Handbook of Forensic Medicine, second edition, Hoboken, NJ: Wiley. ISBN: 978-1-119-64855-0"},{"key":"3865_CR2","doi-asserted-by":"crossref","unstructured":"Saukko P, Knight B (2016) Knight\u2019s Forensic Pathology. 4th edition, CRC Press, Boca Raton. eBook ISBN9780429102356","DOI":"10.1201\/b13266"},{"key":"3865_CR3","unstructured":"Rutty G (2005) Essentials of autopsy practice, current methods and modern trends, 3rd edition. Springer, London. ISBN-13: 978-1852339678"},{"issue":"5","key":"3865_CR4","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1148\/rg.265065001","volume":"26","author":"R Dirnhofer","year":"2006","unstructured":"Dirnhofer R, Jackowski C, Vock P, Potter K, Thali MJ (2006) Virtopsy: minimally invasive, imaging-guided virtual autopsy. Radiographics 26(5):1305\u20131333","journal-title":"Radiographics"},{"issue":"2","key":"3865_CR5","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1520\/JFS2002166","volume":"48","author":"MJ Thali","year":"2003","unstructured":"Thali MJ, Yen K, Schweitzer W, Vock P, Boesch C, Ozdoba C, Schroth G, Ith M, Sonnenschein M, Doernhoefer T, Scheurer E, Plattner T, Dirnhofer R (2003) Virtopsy, a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI)--a feasibility study. J Forensic Sci 48(2):386\u2013403","journal-title":"J Forensic Sci"},{"issue":"2","key":"3865_CR6","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s00428-019-02562-4","volume":"475","author":"N Norberti","year":"2019","unstructured":"Norberti N, Tonelli P, Giaconi C, Nardi C, Focardi M, Nesi G, Miele V, Colagrande S (2019) State of the art in post-mortem computed tomography: a review of current literature. Virchows Arch 475(2):139\u2013150","journal-title":"Virchows Arch"},{"issue":"4","key":"3865_CR7","doi-asserted-by":"publisher","first-page":"W325","DOI":"10.2214\/AJR.12.10283","volume":"202","author":"PM Flach","year":"2014","unstructured":"Flach PM, Thali MJ, Germerott T (2014) Times have changed! Forensic radiology\u2013a new challenge for radiology and forensic pathology. AJR Am J Roentgenol 202(4):W325\u2013W334","journal-title":"AJR Am J Roentgenol"},{"issue":"10095","key":"3865_CR8","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/S0140-6736(17)31828-7","volume":"390","author":"C O\u2019Donnell","year":"2017","unstructured":"O\u2019Donnell C, Lynch M, Woodford N (2017) Can post-mortem CT and angiography provide all the answers? Lancet 390(10095):646\u2013647","journal-title":"Lancet"},{"issue":"2","key":"3865_CR9","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1080\/20961790.2017.1330738","volume":"2","author":"S Grabherr","year":"2017","unstructured":"Grabherr S, Egger C, Vilarino R, Campana L, Jotterand M, Dedouit F (2017) Modern post-mortem imaging: an update on recent developments. Forensic Sci Res 2(2):52\u201364","journal-title":"Forensic Sci Res"},{"issue":"5","key":"3865_CR10","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.legalmed.2010.05.005","volume":"12","author":"A Christe","year":"2010","unstructured":"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\u2013222","journal-title":"Leg Med (Tokyo)"},{"issue":"2","key":"3865_CR11","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.jcmg.2007.11.005","volume":"1","author":"A Wolak","year":"2008","unstructured":"Wolak A, Gransar H, Thomson LE, Friedman JD, Hachamovitch R, Gutstein A, Shaw LJ, Polk D, Wong ND, Saouaf R, Hayes SW, Rozanski A, Slomka PJ, Germano G, Berman DS (2008) Aortic size assessment by noncontrast cardiac computed tomography: normal limits by age, gender, and body surface area. JACC Cardiovasc Imaging 1(2):200\u2013209","journal-title":"JACC Cardiovasc Imaging"},{"issue":"1\u20133","key":"3865_CR12","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.forsciint.2012.04.037","volume":"225","author":"N Takahashi","year":"2013","unstructured":"Takahashi N, Higuchi T, Hirose Y, Yamanouchi H, Takatsuka H, Funayama K (2013) Changes in aortic shape and diameters after death: comparison of early postmortem computed tomography with antemortem computed tomography. Forensic Sci Int 225(1\u20133):27\u201331","journal-title":"Forensic Sci Int"},{"issue":"10","key":"3865_CR13","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1007\/s11604-012-0134-z","volume":"30","author":"H Hyodoh","year":"2012","unstructured":"Hyodoh H, Sato T, Onodera M, Washio H, Hasegawa T, Hatakenaka M (2012) Vascular measurement changes observed using postmortem computed tomography. Jpn J Radiol 30(10):840\u2013845","journal-title":"Jpn J Radiol"},{"issue":"6","key":"3865_CR14","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1007\/s00414-013-0955-z","volume":"128","author":"H Okuma","year":"2014","unstructured":"Okuma H, Gonoi W, Ishida M, Shintani Y, Takazawa Y, Fukayama M, Ohtomo K (2014) Greater thickness of the aortic wall on postmortem computed tomography compared with antemortem computed tomography: the first longitudinal study. Int J Legal Med 128(6):987\u2013993","journal-title":"Int J Legal Med"},{"issue":"7","key":"3865_CR15","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1007\/s11604-019-00841-3","volume":"37","author":"N Takahashi","year":"2019","unstructured":"Takahashi N, Yajima K, Otaki M, Yoshikawa Y, Ishihara A, Sato Y, Higuchi T, Takatsuka H (2019) Postmortem volume change of the spleen and kidney on early postmortem computed tomography: comparison with antemortem computed tomography. Jpn J Radiol 37(7):534\u2013542","journal-title":"Jpn J Radiol"},{"issue":"8","key":"3865_CR16","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/j.jflm.2013.09.026","volume":"20","author":"N Ishikawa","year":"2013","unstructured":"Ishikawa N, Nishida A, Miyamori D, Kubo T, Ikegaya H (2013) Estimation of postmortem time based on aorta narrowing in CT imaging. J Forensic Leg Med 20(8):1075\u20131077","journal-title":"J Forensic Leg Med"},{"key":"3865_CR17","unstructured":"Shiotani S, Kohno M, Ohashi N, Yamazaki K, Nakayama H, Watanabe K, Itai Y (2003) Dilatation of the heart on postmortem computed tomography (PMCT): comparison with live CT. Radiat Med 21(1):29\u201335"},{"issue":"1","key":"3865_CR18","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1097\/PAF.0b013e3181c65e1a","volume":"31","author":"AD Levy","year":"2010","unstructured":"Levy AD, Harcke HT, Mallak CT (2010) Postmortem imaging: MDCT features of postmortem change and decomposition. Am J Forensic Med Pathol 31(1):12\u201317","journal-title":"Am J Forensic Med Pathol"},{"issue":"4","key":"3865_CR19","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1007\/s00414-023-02999-y","volume":"137","author":"C Egger","year":"2023","unstructured":"Egger C, Wiskott K, Vaucher P, Suppan L, Doenz F, Bize P, Grabherr S (2023) Post-mortem changes of the vascular system-a thanatological study using multidetector computed tomography. Int J Legal Med 137(4):1109\u20131115","journal-title":"Int J Legal Med"},{"issue":"1","key":"3865_CR20","doi-asserted-by":"publisher","first-page":"209","DOI":"10.2214\/AJR.05.0222","volume":"187","author":"E Aghayev","year":"2006","unstructured":"Aghayev E, Sonnenschein M, Jackowski C, Thali M, Buck U, Yen K, Bolliger S, Dirnhofer R, Vock P (2006) Postmortem radiology of fatal hemorrhage: measurements of cross-sectional areas of major blood vessels and volumes of aorta and spleen on MDCT and volumes of heart chambers on MRI. AJR Am J Roentgenol 187(1):209\u2013215","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"3865_CR21","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1007\/s00414-014-1075-0","volume":"129","author":"N Sogawa","year":"2015","unstructured":"Sogawa N, Michiue T, Ishikawa T, Inamori-Kawamoto O, Oritani S, Maeda H (2015) Postmortem CT morphometry of great vessels with regard to the cause of death for investigating terminal circulatory status in forensic autopsy. Int J Legal Med 129(3):551\u2013558","journal-title":"Int J Legal Med"},{"key":"3865_CR22","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s00414-012-0686-6","volume":"126","author":"C Egger","year":"2012","unstructured":"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 126:559\u2013566","journal-title":"Int J Legal Med"},{"key":"3865_CR23","volume-title":"Nonparametric Statistics for the Behavioral Sciences","author":"SCN Siegel","year":"1988","unstructured":"Siegel SCN (1988) Nonparametric Statistics for the Behavioral Sciences. McGraw-Hill Book Company, New York. International Edition"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-03865-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-026-03865-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-03865-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:24:38Z","timestamp":1783319078000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00414-026-03865-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":23,"alternative-id":["3865"],"URL":"https:\/\/doi.org\/10.1007\/s00414-026-03865-3","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"value":"0937-9827","type":"print"},{"value":"1437-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"19 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure<!--Emphasis Type='Bold' removed-->statement"}},{"value":"No AI Tools were used in the creation of this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"AI statement"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}