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Objective <p>To systematically evaluate the diagnostic performance of postmortem computed tomography (PMCT) versus traditional autopsy in the detection of fracture.</p> Methods <p>The database of PubMed, Cochrane Library, Embase, and Web of Science were searched to screen the studies comparing PMCT and autopsy in fracture detection from 1 January 1994 to 23 January 2025. Relevant data was extracted for calculating sensitivity and specificity. The QUADAS-2 tool was used for bias assessment and a random effects model was used for meta-analysis.</p> Results <p>A total of 22 studies were included in the meta-analysis containing 1757 fracture cases, covering 7 anatomical sites. All deceased were scanned on multi-slice scanners with comparable parameters. Images were evaluated by radiologists or pathologists. The meta-analysis found that the pooled sensitivity and specificity were 0.87 (95% CI: 0.85–0.89) and 0.97 (95% CI: 0.97–0.98) for PMCT, respectively. Compared to conventional autopsy, positive likelihood ratio (PLR) was 19.74 (95% CI: 12.66–30.79), negative likelihood ratio (NLR) was 0.15 (95% CI: 0.11–0.20), and the area under the receiver operating characteristic curve (AUC) was 0.97.</p> Conclusion <p>By Demonstrating high diagnostic efficacy for fracture detection, PMCT provides the valuable adjunctive support to traditional autopsy. It can improve the precision and efficiency of forensic examination.</p>

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Comparison of the diagnostic efficacy of postmortem computed tomography and traditional autopsy in fracture detection: a meta-analysis

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Jia-ying Han,
  • Yang Li,
  • Xi Xia,
  • Si-wen Wang,
  • Yun-zhou Chen,
  • Mao-ling Sun,
  • Jia-xin Xing,
  • Yang Zhong,
  • Xu Wu,
  • Jun Yao

摘要

Objective

To systematically evaluate the diagnostic performance of postmortem computed tomography (PMCT) versus traditional autopsy in the detection of fracture.

Methods

The database of PubMed, Cochrane Library, Embase, and Web of Science were searched to screen the studies comparing PMCT and autopsy in fracture detection from 1 January 1994 to 23 January 2025. Relevant data was extracted for calculating sensitivity and specificity. The QUADAS-2 tool was used for bias assessment and a random effects model was used for meta-analysis.

Results

A total of 22 studies were included in the meta-analysis containing 1757 fracture cases, covering 7 anatomical sites. All deceased were scanned on multi-slice scanners with comparable parameters. Images were evaluated by radiologists or pathologists. The meta-analysis found that the pooled sensitivity and specificity were 0.87 (95% CI: 0.85–0.89) and 0.97 (95% CI: 0.97–0.98) for PMCT, respectively. Compared to conventional autopsy, positive likelihood ratio (PLR) was 19.74 (95% CI: 12.66–30.79), negative likelihood ratio (NLR) was 0.15 (95% CI: 0.11–0.20), and the area under the receiver operating characteristic curve (AUC) was 0.97.

Conclusion

By Demonstrating high diagnostic efficacy for fracture detection, PMCT provides the valuable adjunctive support to traditional autopsy. It can improve the precision and efficiency of forensic examination.