{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T11:09:22Z","timestamp":1780312162493,"version":"3.54.0"},"reference-count":19,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract The postmortem diagnosis of drowning is a challenge for forensic medicine. The objective of this review was to list the findings described in reports of postmortem computed tomography (PMCT) examinations and autopsies of drowning victims, as well as to show how PMCT facilitates the diagnosis. The PubMed, Google Scholar, the Brazilian Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior (CAPES, Office for the Advancement of Higher Education) Journals, and the International Prospective Register of Systematic Reviews (PROSPERO) databases were searched. The 17 studies included evaluated a collective total of 726 bodies of drowning victims and 477 bodies of people who died from other causes. Different PMCT protocols were used, some encompassing whole-body scans and others including scans only from the skull to the pelvis, with different slice thicknesses, all without the use of contrast. The finding most commonly described was fluid in the paranasal sinuses, mastoid air cells, and airways, referred to as specific for drowning if frothy, containing dense sediment, or both. A cutoff of 37.77 HU for the density of fluid in the paranasal sinuses was suggested to characterize drowning in salt water. Paltauf spots were detected only at autopsy. Although PMCT has proven to be a useful tool in making this diagnosis, it is too early to predict whether it can replace conventional autopsy. Current limitations include the absence of established protocols, a shortage of forensic radiologists, and low availability of CT scanners at forensic medicine facilities.<\/jats:p>","DOI":"10.1590\/0100-3984.2025.0048","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:45:08Z","timestamp":1780310708000},"source":"Crossref","is-referenced-by-count":0,"title":["Contribution of computed tomography in the postmortem diagnosis of drowning: a systematic review"],"prefix":"10.1590","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1758-8456","authenticated-orcid":false,"given":"Rachel","family":"Zeitoune","sequence":"first","affiliation":[{"name":"Universidade do Estado de S\u00e3o Paulo (USP),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9375-6146","authenticated-orcid":false,"given":"Raquel Martins","family":"Loureiro","sequence":"additional","affiliation":[{"name":"Universidade do Estado de S\u00e3o Paulo (USP),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1473-4480","authenticated-orcid":false,"given":"N\u00edvia Abadia Maciel de Melo","family":"Matias","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Legal da Pol\u00edcia Civil do Distrito Federal (IML\/ PCDF),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4266-0117","authenticated-orcid":false,"given":"Carmen Silvia Molleis Galego","family":"Miziara","sequence":"additional","affiliation":[{"name":"Universidade do Estado de S\u00e3o Paulo (USP),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","series-title":"Drowning [homepage on the Internet]"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"283e90","DOI":"10.1007\/s00330-007-0745-4","article-title":"Drowning\u2013post-mortem imaging findings by computed tomography","volume":"18","author":"Christe A","year":"2008","journal-title":"Eur Radiol"},{"key":"ref3","first-page":"e562e6","article-title":"Diagnosis of drowning using post-mortem computed tomography based on the volume 0100-3984 \u00a9 Col\u00e9gio Brasileiro de Radiologia e Diagn\u00f3stico por Imagem and density of fluid accumulation in the maxillary and sphenoid sinuses","volume":"82","author":"Kawasumi Y","year":"2013","journal-title":"Eur J Radiol"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"3953","DOI":"10.1016\/j.ejrad.2012.08.011","article-title":"Assessment of the relation-ship between drowning and fluid accumulation in the paranasal sinuses on post-mortem computed tomography","volume":"81","author":"Kawasumi Y","year":"2012","journal-title":"Eur J Radiol"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.radi.2023.12.001","article-title":"Assessment of maxillary sinus fluid volume for postmortem diagnosis of drowning","volume":"30","author":"Kakimoto Y","year":"2024","journal-title":"Radiography"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"590","DOI":"10.23907\/2015.063","article-title":"The Current and Potential Fu-ture Role of Postmortem Computed Tomography in Medicolegal Death Investigation","volume":"5","author":"Daly B","year":"2015","journal-title":"Acad. Forensic Pathol"},{"issue":"7","key":"ref7","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1007\/s11604-014-0326-9","article-title":"Postmortem lung features in drowning cases on computed tomography","volume":"32","author":"Usui A","year":"2014","journal-title":"Jpn J Radiol"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1007\/s00330-015-3909-7","article-title":"Distinction between saltwa-ter drowning and freshwater drowning by assessment of sinus fluid on post-mortem computed tomography","volume":"26","author":"Kawasumi Y","year":"2016","journal-title":"Eur Radiol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"102551","DOI":"10.1016\/j.jflm.2023.102551","article-title":"The significance of evaluating sphenoid sinus fluid by postmortem computed tomography in cases of drowning","volume":"97","author":"Heo JH","year":"2023","journal-title":"J Forensic Leg 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Int"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.forsciint.2017.11.030","article-title":"Postmortem computed tomography findings in cases of bath-related death: Applicability and limitation in forensic practice","volume":"282","author":"Mishima S","year":"2018","journal-title":"Forensic Sci Int"},{"key":"ref14","first-page":"1","article-title":"Postmortem chest computed tomog-raphy for the diagnosis of drowning: a feasibility study","author":"Jian J","year":"2019","journal-title":"Forensic Sciences Research"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jofri.2017.02.002","article-title":"Drowning investigated by post mor-tem computed tomography and autopsy","volume":"9","author":"Leth PM","year":"2017","journal-title":"Journal of Forensic Radiology and Imaging"},{"issue":"4","key":"ref16","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1007\/s00414-024-03173-8","article-title":"Postmortem CT analysis of paranasal sinuses using an experimental model of drowning","volume":"138","author":"Tyr A","year":"2024","journal-title":"Int J Legal Med"},{"issue":"1","key":"ref17","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00414-014-1037-6","article-title":"Can post-mortem CT reliably distinguish between drowning and non-drowning asphyxiation?","volume":"129","author":"Van Hoyweghen AJL","year":"2014","journal-title":"International Journal of Legal Medicine"},{"issue":"3","key":"ref18","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1148\/radiol.2433061009","article-title":"Virtual Autopsy: Two-and Three-dimensional Multidetector CT Findings in Drowning with Autopsy Comparison","volume":"243","author":"Levy AD","year":"2007","journal-title":"Radiology"},{"issue":"1","key":"ref19","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s00414-018-1850-4","article-title":"Layering of stomach contents in drowning cases in post-mortem computed tomog-raphy compared to forensic autopsy","volume":"133","author":"Gotsmy W","year":"2019","journal-title":"Int J Legal Med"}],"container-title":["Radiologia Brasileira"],"original-title":["Contribui\u00e7\u00e3o da tomografia computadorizada no diagn\u00f3stico post-mortem de afogamento: uma revis\u00e3o sistem\u00e1tica"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0100-39842026000101004&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:45:11Z","timestamp":1780310711000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-39842026000101004&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":19,"alternative-id":["S0100-39842026000101004"],"URL":"https:\/\/doi.org\/10.1590\/0100-3984.2025.0048","relation":{"is-translation-of":[{"id-type":"doi","id":"10.1590\/0100-3984.2025.0048","asserted-by":"subject"}],"has-translation":[{"id-type":"doi","id":"10.1590\/0100-3984.2025.0048","asserted-by":"object"}]},"ISSN":["1678-7099"],"issn-type":[{"value":"1678-7099","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20250048"}}