Postmortem whole-body CT angiography: evaluation of two contrast media solutions.
OBJECTIVE
The objective of our study was to establish a standardized procedure for postmortem whole-body CT-based angiography with lipophilic and hydrophilic contrast media solutions and to compare the results of these two methods.


METHODS
Minimally invasive postmortem CT angiography was performed on 10 human cadavers via access to the femoral blood vessels. Separate perfusion of the arterial and venous systems was established with a modified heart-lung machine using a mixture of an oily contrast medium and paraffin (five cases) and a mixture of a water-soluble contrast medium with polyethylene glycol (PEG) 200 in the other five cases. Imaging was executed with an MDCT scanner.


RESULTS
The minimally invasive femoral approach to the vascular system provided a good depiction of lesions of the complete vascular system down to the level of the small supplying vessels. Because of the enhancement of well-vascularized tissues, angiography with the PEG-mixed contrast medium allowed the detection of tissue lesions and the depiction of vascular abnormalities such as pulmonary embolisms or ruptures of the vessel wall.


CONCLUSIONS
The angiographic method with a water-soluble contrast medium and PEG as a contrast-agent dissolver showed a clearly superior quality due to the lack of extravasation through the gastrointestinal vascular bed and the enhancement of soft tissues (cerebral cortex, myocardium, and parenchymal abdominal organs). The diagnostic possibilities of these findings in cases of antemortem ischemia of these tissues are not yet fully understood.
Ross
Steffen
S
Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland. steffen.ross@irm.unibe.ch
Spendlove
Danny
D
Bolliger
Stephan
S
Christe
Andreas
A
Oesterhelweg
Lars
L
Grabherr
Silke
S
Thali
Michael J
MJ
Gygax
Erich
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001344:Autopsy / Q000379:methods*; D002102:Cadaver; D003287:Contrast Media; D004337:Drug Carriers; D006801:Humans; D007459:Iodized Oil; D008875:Middle Aged; D011092:Polyethylene Glycols; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids
D003287:Contrast Media; D004337:Drug Carriers; D014283:Triiodobenzoic Acids; D011092:Polyethylene Glycols; C053571:iopentol; D007459:Iodized Oil