Postmortem CT Angiography Compared with Autopsy: A Forensic                     Multicenter Study

Grabherr, Silke; Heinemann, Axel; Vogel, H.; Rutty, Guy N.; Morgan, Bruno; Woźniak, Krzysztof; Dédouit, Fabrice; Fischer, Florian; Lochner, Stefanie; Wittig, Holger; Guglielmi, Giuseppe; Eplinius, Franziska; Michaud, Katarzyna; Palmière, Cristian; Chevallier, Coralie; Mangin, Patrice; Grimm, Jochen

doi:10.1148/radiol.2018170559

Cited by 105 publications

(59 citation statements)

References 28 publications

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“…These findings were reaffirmed in a larger European study across nine centres where 500 corpses were subject to post‐mortem CTA followed by conventional autopsy . The results were even more positive for CTA.…”

Section: Early Adoption In the Ukmentioning

confidence: 54%

“…Furthermore, the new gold standard of postmortem investigation should include both CTA and invasive autopsy as both complement each other and yield more accurate results than either on its own. These findings were reaffirmed in a larger European study across nine centres where 500 corpses were subject to post-mortem CTA followed by conventional autopsy [6]. The results were even more positive for CTA.…”

Section: Early Adoption In the Ukmentioning

confidence: 54%

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Alternatives to vivisection

Hunter¹

2019

EMBO Reports

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Section: Early Adoption In the Ukmentioning

confidence: 54%

Section: Early Adoption In the Ukmentioning

confidence: 54%

Alternatives to vivisection

Hunter¹

2019

EMBO Reports

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“…By applying this standardized technique, the vasculature of the head, thorax, and abdomen can be visualized by using the femoral vessels for access. The advantages of this technique over conventional autopsy have been investigated by multiple studies [6,30]. As it allows to investigate the coronary arteries and even gives some information about the myocardium, it is especially useful for investigating SCD [3,5,9,31].…”

Section: Pmamentioning

confidence: 99%

“…Radiological examination has been used in forensic and clinical pathology in specific situations of SD for many years, as an additional diagnostic tool, for documentation and for research, mainly in an academic setting. More recently, tomographic and other forms of digital imaging have been introduced, first as whole-body imaging by postmortem computed tomography (PMCT) and then by postmortem magnetic resonance (PMMR) imaging, with or without additional angiographic methodology [3][4][5][6]. Today, PMCT remains the most widely accessible and the most frequently used of these methods, though limitations of PMCT in natural deaths and especially in cardiovascular pathologies have been reported [7].…”

Section: Introductionmentioning

confidence: 99%

Postmortem imaging as a complementary tool for the investigation of cardiac death

Michaud

Genet

Sabatasso

et al. 2019

Forensic Sciences Research

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In the past 2 decades, modern radiological methods, such as multiple detector computed tomography (MDCT), MDCT-angiography, and cardiac magnetic resonance imaging (MRI) were introduced into postmortem practice for investigation of sudden death (SD), including cases of sudden cardiac death (SCD). In forensic cases, the underlying cause of SD is most frequently cardiovascular with coronary atherosclerotic disease as the leading cause. There are many controversies about the role of postmortem imaging in establishing the cause of death and especially the value of minimally invasive autopsy techniques. This paper discusses the state of the art for postmortem radiological evaluation of the heart compared to classical postmortem examination, especially in cases of SCD. In SCD cases, postmortem CT is helpful to estimate the heart size and to visualize haemopericardium and calcified plaques and valves, as well as to identify and locate cardiovascular devices. Angiographic methods are useful to provide a detailed view of the coronary arteries and to analyse them, especially regarding the extent and location of stenosis and obstruction. In postsurgical cases, it allows verification and documentation of the patency of stents and bypass grafts before opening the body. Postmortem MRI is used to investigate soft tissues such as the myocardium, but images are susceptible to postmortem changes and further work is necessary to increase the understanding of these radiological aspects, especially of the ischemic myocardium. In postsurgery cases, the value of postmortem imaging of the heart is reportedly for the diagnostic and documentation purposes. The implementation of new imaging methods into routine postmortem practice is challenging, as it requires not only an investment in equipment but, more importantly, investment in the expertise of interpreting the images. Once those requirements are implemented, however, they bring great advantages in investigating cases of SCD, as they allow documentation of the body, orientation of sampling for further analyses and gathering of other information that cannot be obtained by conventional autopsy such as a complete visualization of the vascular system using postmortem angiography. KEY POINTSThere are no established guidelines for the interpretation of postmortem imaging examination of the heart At present, postmortem imaging methods are considered as less accurate than the autopsy for cardiac deaths Postmortem imaging is useful as a complementary tool for cardiac deaths There is still a need to validate postmortem imaging in cardiac deaths by comparing with autopsy findings ARTICLE HISTORY

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“…Wagensveld et al evaluated the frequency of total-body computed tomography (CT) and magnetic resonance imaging features of postmortem changes in in-hospital deaths and reported a wide variety of features of postmortem changes [5]. To investigate the accuracy of postmortem imaging, a few groups compared postmortem imaging with conventional autopsy and showed the accuracy of postmortem computed tomography (PMCT) [6,7]. PMCT is useful in detecting gas accumulation inside the body which is an advantage over the conventional autopsy.…”

Section: Introductionmentioning

confidence: 99%

Postmortem computed tomography of gas gangrene with aortic gas in a dialysis patient

et al. 2020

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Recently, postmortem imaging is sometimes used as an alternative to conventional autopsy. However, there are few case reports of postmortem imaging of dialysis patients. Here, we report a fatal case of gas gangrene involving a 76-year-old man who underwent dialysis. He died suddenly before a diagnosis could be established. Immediately after his death, postmortem computed tomography (PMCT) revealed gas accumulation in his right upper extremity and ascending aorta. Gas gangrene progresses rapidly and may sometimes result in sudden death before it is diagnosed. In this case, PMCT findings were useful to diagnose gas gangrene. Intravascular gas is a common finding on PMCT and is generally caused by cardiopulmonary resuscitation and decomposition. However, the detection of gas in the ascending aorta by PMCT was not described previously. Moreover, Gram stain and culture of the exudate showed anaerobic Gram-positive bacilli which suggested that the gas generation in the blood was caused by Clostridia species. To the best our knowledge, this is the first report of a dialysis patient whose cause of death was determined as gas gangrene using PMCT.

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Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study

Cited by 105 publications

References 28 publications

Alternatives to vivisection

Alternatives to vivisection

Postmortem imaging as a complementary tool for the investigation of cardiac death

Postmortem computed tomography of gas gangrene with aortic gas in a dialysis patient

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