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A Minimally Invasive Technique for the Detection and Analysis of Pulmonary Fat Embolism: A Feasibility Study*
Authors:Filograna Laura  Bolliger Stephan A  Kneubuehl Beat  Jackowski Christian  Hatch Gary M  Thali Michael J
Affiliation:Department of Legal Medicine, Centre of Forensic Imaging and Virtopsy, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland. Department of Legal Medicine, Institute of Forensic Medicine, Catholic University of Rome, Largo F. Vito 1, 00168 Rome, Italy. Department of Legal Medicine, Institute of Forensic Medicine, University of Berne, Buehlstrasse 20, 3012 Bern, Switzerland. Department of Legal Medicine, Institute of Forensic Medicine, Post Mortem Imaging Center, University of Zurich, Winterthurerstrasse 190, CH-8057 Zürich, Switzerland.
Abstract:We investigated the feasibility of postmortem percutaneous needle biopsy (PNB) for obtaining pulmonary samples adequate for the study of pulmonary fat embolism (PFE). Samples of both lungs were obtained from 26 cadavers via two different methods: (i) PNB and (ii) the double-edged knife technique, the gold standard at our institute. After water storage and Sudan III staining, six forensic pathologists independently examined all samples for the presence and severity of PFE. The results were compared and analyzed in each case regarding the vitality of the PFE and its relationship to the cause of death. The results showed that PFE was almost identically diagnosed and graded on the samples obtained via both methods. The discrepancies between the two techniques did not affect the diagnoses of vitality or cause of death related to PFE. This study demonstrates the feasibility of the PNB sampling method for the diagnosis and interpretation of PFE in the postmortem setting.
Keywords:forensic science  forensic pathology  virtual autopsy  pulmonary fat embolism  percutaneous needle biopsy  double‐edged knife
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