Peran Ultrasonografi (US) dalam Pemeriksaan Post-Mortem: Sebuah Studi Literatur

Authors

  • Liauw Djai Yen Departemen Forensik dan Medikolegal, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Krida Wacana, Jakarta, Indonesia
  • Alexandra Ambar Saputro Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
  • Michelle Margaretha Suwito Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
  • Eunike Marshya Easter Damanik Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
  • Evellyn Hadiwinata Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
  • Cindy Anastasia Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia
  • Radinka Genevieve Theopilia Sinurat Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia

DOI:

https://doi.org/10.36452/jkdoktmeditek.v32i1.4011

Keywords:

autopsy, forensic, post-mortem, ultrasonography

Abstract

Introduction: The global decline in autopsy rates has raised concerns about its consequences for education and research. Virtual autopsy offers a non-invasive alternative to conventional procedures, avoiding tissue destruction and gaining wider family acceptance. Ultrasonography (US) is widely available, relatively inexpensive, and has emerging potential in post-mortem evaluation. Purpose: To review the role of US as a post-mortem imaging modality as an alternative method to conventional autopsy. Methods: A literature search was conducted in PubMed, Google Scholar, and the Journal of Forensic Sciences for studies published between 2019 and 2025. Eligible designs included prospective diagnostic studies, case reports, systematic reviews, and descriptive observational research. Reported statistical analyses involved sensitivity and specificity calculations, logistic regression, diagnostic accuracy meta-analyses, and Fisher’s exact test (p<0.05). Results: With the advancement of technology, virtual autopsy can provide important information that helps determine the cause and manner of death. Early post-mortem US has been shown to identify aortic dissection, pericardial and pleural effusions, pneumothorax, deep vein thrombosis (DVT), and pulmonary embolism. In forensic practice, US is used as a complementary technique, reducing the need for extensive autopsy exploration and limiting biological exposure risks to forensic staff. Conclusion: Post-mortem US is a practical and effective tool for detecting pathological findings, particularly in resource-limited settings or when infection risk is high. However, its diagnostic performance is constrained by gas artifacts, tissue cooling, and limited access to internal organs. Further research is needed to standardize techniques and validate diagnostic accuracy.

References

Paratz ED, Rowe SJ, Stub D, Pflaumer A, Gerche AL. A systematic review of global autopsy rates in all-cause mortality and young sudden death. Heart Rhythm [Internet]. 2023 [cited 2025 Oct 6];2;607–613. Available from: https://doi.org/10.1016/j.hrthm.2023.01.008

Nweke MC, Omenai SA, Fatunla E, Olusanya A, Onakpoma F, Exenkwa US, et al. The Importance of the Autopsy in Ascertaining the Cause of Death and as an Audit Tool at the University College Hospital, Ibadan. Nigerian Postgraduate Medical Journal [Internet]. 2022 [cited 2025 Oct 6];29:43. Available from: https://doi.org/10.4103/npmj.npmj_503_21

Start RD, Firth JA, Macgillivray F, Cross SS. Have declining clinical necropsy rates reduced the contribution of necropsy to medical research? J Clin Pathol [Internet]. 1995 [cited 2025 Oct 6];48:402–404. Available from: https://doi.org/10.1136/jcp.48.5.402

Loughrey MB, McCluggage WG, Toner PG. The declining autopsy rate and clinician’s attitudes. The Ulster Medical Journal [Internet]. 2000 [cited 2025 Oct 6];69(2):83-89. Available from: https://doi.org/10.1136/jcp.48.5.402

Hoyert DL. The changing profile of autopsied deaths in the United States, 1972-2007. NCHS Data Brief. 67th ed. Hyattsville: MD: National Center for Health Statistics; 2011: p. 1–8.

6. Sieswerda-Hoogendoorn T, van Rijn RR. Current techniques in postmortem imaging with specific attention to paediatric applications. Pediatr Radiol [Internet]. 2010 [cited 2025 Oct 6];40:141–152. Available from: https://doi.org/10.1007/s00247-009-1486-0

Joseph TI, Girish KL, Sathyan P, Kiran MS, Vidya S. Virtopsy: An integration of forensic science and imageology. J Forensic Dent Sci [Internet]. 2017 [cited 2025 Oct 6];9(3):111-114. Available from: https://doi.org/10.4103/jfo.jfds_52_16

Dirnhofer R, Jackowski C, Vock P, Potter K, Thali MJ. VIRTOPSY: minimally invasive, imaging-guided virtual autopsy. Radiographics [Internet]. 2006 [cited 2025 Oct 6];26(5):1305-33. Available from: https://doi.org/10.1148/rg.2650650001

Hao ZR, Wu JD, Liu XS, Chen BZ, Hu T, Xing HW. Application of virtopsy in forensic science. Fa Yi Zue Za Zhi [Internet]. 2007 [cited 2025 Oct 6];23(2):142-4. Available from: https://doi.org/10.4103/jfsm.jfsm_67_20

Stillfried SV, Isfort P, Knüchel-Clarke R. Postmortem imaging procedures: Experiences and perspectives. Pathologe [Internet]. 2017 [cited 2025 Oct 6];38(5):412-415. Available from: https://doi.org/10.1007/s00292-017-0344-3

Christe A, Flach P, Ross S, Spendlove D, Bolliger S, Vock P, et al. Clinical radiology and postmortem imaging (Virtopsy) are not the same: Specific and unspecific postmortem signs. Leg Med (Tokyo) [Internet]. 2010 [cited 2025 Oct 6];12:215–222. Available from: https://doi.org/10.1016/j.legalmed.2010.05.005

Roberts ISD, Benamore RE, Benbow EW, Lee SH, Harris JN, Jackson A, et al. Post-mortem imaging as an alternative to autopsy in the diagnosis of adult deaths: a validation study. Lancet [Internet]. 2012 [cited 2025 Oct 6];379:136–142. Available from: https://doi.org/10.1016/S0140-6736(11)61483-9

Jalalzadeh H, Giannakopoulos GF, Berger FH, Fronczek J, Van de Goot FRW, Reijnders UJ, et al. Post-mortem imaging compared with autopsy in trauma victims--A systematic review. Forensic Sci Int [Internet]. 2015 [cited 2025 Oct 6];257:29–48. Available from: https://doi.org/10.1016/j.forsciint.2015.07.026

Heinemann A, Vogel H, Heller M, Tzikas A, Püschel K. Investigation of medical intervention with fatal outcome: the impact of post-mortem CT and CT angiography. Radiol Med [Internet]. 2015 [cited 2025 Oct 6];120:835–845. Available from: https://doi.org/10.1007/s11547-015-0574-5

Thomsen T, Blaivas M, Sadiva P, Kripfgans OD, Chan HL, Dong Y, et al. Ultrasonography on the non-living. Current approaches. Med Ultrason [Internet]. 2023 [cited 2025 Oct 6];25:56–65. Available from: https://doi.org/10.11152/mu-3490

Kanchan T, Shrestha R, Krishan K. Post-mortem ultrasonography: a safer alternative to autopsies in COVID-19 deaths. J Ultrasound [Internet]. 2021 [cited 2025 Oct 6];24:577–578. Available from: https://doi.org/10.1007/s40477-020-00531-1

Terence Azeke A, Schädler J, Ondruschka B, Steurer S, Möbius D, Fitzek A. Minimally Invasive Tissue Sampling via Post Mortem Ultrasound: A Feasible Tool (Not Only) in Infectious Diseases—A Case Report. Diagnostics [Internet]. 2023 [cited 2025 Oct 6];13:2643. Available from: https://doi.org/ 10.3390/diagnostics13162643

Jangid C, Dalal J, Kumari K, et al. From Traditional to Virtual: The Evolving Landscape of Autopsy Techniques in Forensic Science. Journal of Indian Academy of Forensic Medicine [Internet]. 2024 [cited 2025 Oct 6];46:545–552. Available from: https://doi.org/10.1177/09710973251327639

Kang X, Shelmerdine SC, Hurtado I, Bevilacqua E, Hutchinson C, Mandalia U, et al. Postmortem examination of human fetuses: comparison of two-dimensional ultrasound with invasive autopsy. Ultrasound in Obstetrics & Gynecology [Internet]. 2019 [cited 2025 Oct 6];53:229–238. Available from: https://doi.org/10.1002/uog.18828

O’Keefe H, Shenfine R, Brown M, Beyer F, Rankin J. Are non-invasive or minimally invasive autopsy techniques for detecting cause of death in prenates, neonates and infants accurate? A systematic review of diagnostic test accuracy. BMJ Open [Internet]. 2023 [cited 2025 Oct 6];13:e064774. Available from: https://doi.org/10.1136/bmjopen-2022-064774

Published

2026-02-13

How to Cite

Yen, L. D. ., Saputro, A. A., Suwito, M. M., Damanik, E. M. E., Hadiwinata, E. ., Anastasia, C. ., & Sinurat, R. G. T. . (2026). Peran Ultrasonografi (US) dalam Pemeriksaan Post-Mortem: Sebuah Studi Literatur. Jurnal Kedokteran Meditek, 32(1). https://doi.org/10.36452/jkdoktmeditek.v32i1.4011

Issue

Section

Research Article