False positive aortic dissection on postmortem computed tomography

Blanc-Louvry, Isabelle Le; Ledoux, Kathy; Mogdad, Benjamin; Lagroy, Emma; Dacher, J.-N.; Tournel, Gilles

doi:10.1016/j.forsciint.2015.06.014

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…In addition, significant collapse of the aorta due to aortic rupture can result in false negative results. 20 In such cases, it is necessary to employ additional post-mortem imaging (such as magnetic resonance imaging) and autopsy to make a definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest evaluated by non-contrast computed tomography

Takeuchi

Yamaguchi

Soejima

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Background The exact epidemiology of acute aortic dissection, including cases of out-of-hospital cardiopulmonary arrest, is unclear. We aimed to investigate the incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest transferred to our institution and validate the related factors to out-of-hospital cardiopulmonary arrest in Stanford type A acute aortic dissection. Methods We retrospectively reviewed the acute-phase computed tomography data of patients with out-of-hospital cardiopulmonary arrest who visited our hospital between 1 January 2015 and 31 December 2017. Results Among 1011 consecutive patients with out-of-hospital cardiopulmonary arrest, excluding those aged 17 years and younger and exogenous out-of-hospital cardiopulmonary arrest, such as suicide and trauma, 934 underwent computed tomography examination and 71 (7.6%) were diagnosed with acute aortic dissection: 66 with Stanford type A and five with type B acute aortic dissection (out-of-hospital cardiopulmonary arrest group). Seventy-five patients without out-of-hospital cardiopulmonary arrest with Stanford type A acute aortic dissection visited our institution during the same period (non-out-of-hospital cardiopulmonary arrest group). Age, incidence of massive bloody pericardial effusion and massive intrathoracic haemorrhage were significantly higher in the out-of-hospital cardiopulmonary arrest than in the non-out-of-hospital cardiopulmonary arrest group (78 ± 8 years, 72.7% and 24.2% vs. 70 ± 13 years, 26.7% and 1.3%, respectively; all P < 0.01). These variables were independently related to out-of-hospital cardiopulmonary arrest. Conclusions There may be more patients with acute aortic dissection with out-of-hospital cardiopulmonary arrest than previously thought. Aortic rupture into the pericardial space or thoracic cavity is the major cause of out-of-hospital cardiopulmonary arrest in these cases. Non-contrast computed tomography can be used to diagnose acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest. Our study is one of a few to evaluate the real circumstances surrounding acute aortic dissection and its epidemiology.

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Section: Discussionmentioning

confidence: 99%

Incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest evaluated by non-contrast computed tomography

Takeuchi

Yamaguchi

Soejima

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…Reported challenges are related both to soft tissues [17][18][19] and to bones konieczna jest ostrożna interpretacja obrazu z uwagi na możliwe trudności interpretacyjne. Opisywane zagrożenia dotyczą zarówno tkanek miękkich [17][18][19], jak i kostnych [20]. Dlatego jako złoty standard należy przyjmować wzajemną konfrontację wyników badania PMCT i sądowo-lekarskiej sekcji zwłok.…”

Section: Discussionunclassified

Usefulness of post mortem computed tomography versus conventional forensic autopsy of road accident victims (drivers and passengers)

Moskała¹,

Woźniak²,

Kluza³

et al. 2017

amsik

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StreszczenieCel pracy: Problematyka zgonów osób z wnętrza samochodu w wyniku wypadków komunikacyjnych stanowi istotną grupę zagadnień w medycynie sądowej. Opiniowanie w tym zakresie obejmuje przede wszystkim określenie przyczyny zgonu oraz udział medyka sądowego w procesie rekonstrukcji przebiegu zdarzenia drogowego poprzez określenie mechanizmu powstania obrażeń ciała. Zakres opinii, jej dokładność i szczegółowość w dużym stopniu zależą od zakresu sądowo-lekarskiego badania pośmiertnego. W tym kontekście istotne są techniki zwiększające możliwości standardowej sekcji zwłok. W pracy przedstawiono wyniki pośmiertnego badania tomografią komputerową (post mortem computed tomography -PMCT) ofiar wypadków drogowych z wnętrza samochodu (kierowca, pasażer), które zestawiono z wynikami standardowej sekcji zwłok, określając zakres, w jakim badanie PMCT zwiększa w sposób istotny możliwości badania pośmiertnego. Materiał i metody: Analizie poddano 118 przypadków ofiar z wnętrza samochodu (kierowcy i pasażerowie), badanych w latach 2012-2014. Sekcja zwłok w każdym przypadku poprzedzona była badaniem PMCT przy użyciu aparatu Somatom Emotion 16 (Siemens AG, Niemcy). Wyniki: Wyniki badań zaprezentowano w formie tabelarycznej. Wnioski: Pośmiertne badanie tomografią komputerową w przypadku ofiar wypadków komunikacyjnych (kierowca -pasażer) ma istotne znaczenie dla zwiększenia szczegółowości wyników, zwłaszcza w zakresie obrażeń kostnych i przestrzeni gazowych.Słowa kluczowe: wypadki drogowe, medycyna sądowa, pośmiertna tomografia komputerowa. AbstractAim of the study: Deaths of in-vehicle victims (drivers and passengers) of road accidents represent a significant group of issues addressed by forensic medicine. Expressing opinions in this regard involves first of all the determination of the cause of death and the forensic pathologist's participation in the process of road accident reconstruction through defining the mechanism of bodily harm. The scope of the opinion as well as its accuracy and degree of detail largely depend on the scope of forensic autopsy. In this context, techniques that broaden the capabilities of standard autopsy are of particular importance. This paper compares the results of post mortem computed tomography (PMCT) of road Praca oryginalna Original paper archiwum medycyny sądowej i kryminologii

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Experimental Insight into the Hemodynamics and Perfusion of Radiological Contrast in Patent and Non-patent Aortic Dissection Models

Salameh

Saade

Oweis

2019

Cardiovasc Eng Tech

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False positive aortic dissection on postmortem computed tomography

Cited by 5 publications

References 15 publications

Incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest evaluated by non-contrast computed tomography

Incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest evaluated by non-contrast computed tomography

Usefulness of post mortem computed tomography versus conventional forensic autopsy of road accident victims (drivers and passengers)

Experimental Insight into the Hemodynamics and Perfusion of Radiological Contrast in Patent and Non-patent Aortic Dissection Models

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