Early postmortem changes in the pulmonary artery and veins: An antemortem and postmortem computed tomography study

Objectives: To compare the diameter of pulmonary vessels on antemortem (AMCT) and postmortem computed tomography (PMCT). Materials and Methods: This retrospective case-control study included 641 patients who underwent AMCT within 30 days before death, died in the hospital, and underwent PMCT and conventional autopsy, as a reference standard, soon after death between 2009 and 2020 at a university hospital. The control group comprised 8 patients without lung and pulmonary vessel abnormalities, whereas the heart failure group comprised 16 patients who died of congestive heart failure. The diameters of the main pulmonary artery and bilateral superior and inferior pulmonary veins were measured on AMCT and PMCT images and statistically analyzed (240 vessels in total). Results: In both groups, PMCT resulted in significantly smaller main pulmonary artery diameters compared to AMCT. The control group had greater pulmonary vein diameters compared to the heart failure group after death, although the difference did not reach statistical significance. Comparison between the groups revealed that the heart failure group had significantly greater tendency for postmortem decrease in the pulmonary vein diameters compared to the control group. Conclusion: Our findings showed that the main pulmonary artery diameter decreases after death. Moreover, patients who died of congestive heart failure had a greater tendency for decreased pulmonary vein diameter compared to those who died without cardiopulmonary abnormalities.