Journal Article

Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method

Patrice, Mangin, Silke, Grabherr, Christine, Chevallier, Paul, Vaucher, Alejandro, Dominguez, Francesco, Doenz, Cristian, Palmiere, Stefano, Binaghi

2013

Overview

Purpose Postmortem computed tomography angiography (PMCTA) was introduced into forensic investigations a few years ago. It provides reliable images that can be consulted at any time. Conventional autopsy remains the reference standard for defining the cause of death, but provides only limited possibility of a second examination. This study compares these two procedures and discusses findings that can be detected exclusively using each method. Materials and methods This retrospective study compared radiological reports from PMCTA to reports from conventional autopsy for 50 forensic autopsy cases. Reported findings from autopsy and PMCTA were extracted and compared to each other. PMCTA was performed using a modified heart–lung machine and the oily contrast agent Angiofil® (Fumedica AG, Muri, Switzerland). Results PMCTA and conventional autopsy would have drawn similar conclusions regarding causes of death. Nearly 60 % of all findings were visualized with both techniques. PMCTA demonstrates a higher sensitivity for identifying skeletal and vascular lesions. However, vascular occlusions due to postmortem blood clots could be falsely assumed to be vascular lesions. In contrast, conventional autopsy does not detect all bone fractures or the exact source of bleeding. Conventional autopsy provides important information about organ morphology and remains the only way to diagnose a vital vascular occlusion with certitude. Conclusion Overall, PMCTA and conventional autopsy provide comparable findings. However, each technique presents advantages and disadvantages for detecting specific findings. To correctly interpret findings and clearly define the indications for PMCTA, these differences must be understood.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adipose Tissue - pathology / Adolescent / Adult / Aged / Aged, 80 and over / Angiography / Autopsies / Autopsy / Bleeding / Blood Vessels - pathology / Bone and Bones - pathology / Bones / Cause of Death / Contrast agents / Contrast Media / Death & dying / Female / Forensic Medicine / Forensic Pathology - methods / Fractures / Fractures, Bone - pathology / Humans / Legal medicine / Lesions / Male / Medical imaging / Medical Law / Medicine / Medicine & Public Health / Middle Aged / Morphology / Multidetector Computed Tomography / Original Article / Retrospective Studies / Tomography / Young Adult