ArticleForensic science, medicine, and pathology2014
Cardiothoracic ratio in postmortem computed tomography: reliability and threshold for the diagnosis of cardiomegaly.
Article in Forensic science, medicine, and pathology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 34 citations in OpenAlex.
- Multiphase post-mortem CT angiography (MPMCTA) in sudden natural death: diagnostic contribution and workflow impact in a forensic autopsy series.Forensic science, medicine, and pathology · 2026Article
- Post-mortem cardiomegaly descriptor: Call for consistent criteria.Journal of forensic sciences · 2025Article
- The current state of forensic imaging - post mortem imaging.International journal of legal medicine · 2025Review
- Automated diagnosis of flatfoot using cascaded convolutional neural network for angle measurements in weight-bearing lateral radiographs.European radiology · 2023Article
- Evaluation of the mediastinal-thoracic volume ratio on postmortem computed tomography.International journal of legal medicine · 2021Article
- The Association of CT-measured Cardiac Indices with Lung Involvement and Clinical Outcome in Patients with COVID-19.Academic radiology · 2021Article
- The clinical associations with cardiomegaly in patients undergoing evaluation for pulmonary hypertension.Journal of community hospital internal medicine perspectives · 2021Article
- Postmortem imaging as a complementary tool for the investigation of cardiac death.Forensic sciences research · 2019Review
- Thoracic trauma in fatal falls from height - Traumatic pneumopericardium correlates with height of fall and severe injury.Forensic science, medicine, and pathology · 2018Article
- The role of angiography in the congruence of cardiovascular measurements between autopsy and postmortem imaging.International journal of legal medicine · 2018Article
- Accuracy of non-contrast PMCT for determining cause of death.Forensic science, medicine, and pathology · 2017Article
- Forensic postmortem computed tomography: volumetric measurement of the heart and liver.Forensic science, medicine, and pathology · 2016Article
- The cardiothoracic ratio on post-mortem computer tomography.International journal of legal medicine · 2016Article
- Trapped lung secondary to cardiomegaly in a 78 year-old male with congestive heart failure.Respiratory medicine case reports · 2016Article
- Smaller but denser: postmortem changes alter the CT characteristics of subdural hematomas.Forensic science, medicine, and pathology · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this study was to evaluate the reliability of the cardiothoracic ratio (CTR) in postmortem computed tomography (PMCT) and to assess a CTR threshold for the diagnosis of cardiomegaly based on the weight of the heart at autopsy. PMCT data of 170 deceased human adults were retrospectively evaluated by two blinded radiologists. The CTR was measured on axial computed tomography images and the actual cardiac weight was weighed at autopsy. Inter-rater reliability, sensitivity, and specificity were calculated. Receiver operating characteristic curves were calculated to assess enlarged heart weight by CTR. The autopsy definition of cardiomegaly was based on normal values of the Zeek method (within a range of both, one or two SD) and the Smith method (within the given range). Intra-class correlation coefficients demonstrated excellent agreements (0.983) regarding CTR measurements. In 105/170 (62 %) cases the CTR in PMCT was >0.5, indicating enlarged heart weight, according to clinical references. The mean heart weight measured in autopsy was 405 ± 105 g. As a result, 114/170 (67 %) cases were interpreted as having enlarged heart weights according to the normal values of Zeek within one SD, while 97/170 (57 %) were within two SD. 100/170 (59 %) were assessed as enlarged according to Smith's normal values. The sensitivity/specificity of the 0.5 cut-off of the CTR for the diagnosis of enlarged heart weight was 78/71 % (Zeek one SD), 74/55 % (Zeek two SD), and 76/59 % (Smith), respectively. The discriminative power between normal heart weight and cardiomegaly was 79, 73, and 74 % for the Zeek (1SD/2SD) and Smith methods respectively. Changing the CTR threshold to 0.57 resulted in a minimum specificity of 95 % for all three definitions of cardiomegaly. With a CTR threshold of 0.57, cardiomegaly can be identified with a very high specificity. This may be useful if PMCT is used by forensic pathologists as a screening tool for medico-legal autopsies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.