Multi-phase post-mortem CT angiography: development of a standardized protocol.
The objective of this work was to develop an easily applicable technique and a standardized protocol for high-quality post-mortem angiography. This protocol should (1) increase the radiological interpretation by decreasing artifacts due to the perfusion and by reaching a complete filling of the vascular system and (2) ease and standardize the execution of the examination. To this aim, 45 human corpses were investigated by post-mortem computed tomography (CT) angiography using different perfusion protocols, a modified heart-lung machine and a new contrast agent mixture, specifically developed for post-mortem investigations. The quality of the CT angiographies was evaluated radiologically by observing the filling of the vascular system and assessing the interpretability of the resulting images and by comparing radiological diagnoses to conventional autopsy conclusions. Post-mortem angiography yielded satisfactory results provided that the volumes of the injected contrast agent mixture were high enough to completely fill the vascular system. In order to avoid artifacts due to the post-mortem perfusion, a minimum of three angiographic phases and one native scan had to be performed. These findings were taken into account to develop a protocol for quality post-mortem CT angiography that minimizes the risk of radiological misinterpretation. The proposed protocol is easy applicable in a standardized way and yields high-quality radiologically interpretable visualization of the vascular system in post-mortem investigations.
University Center of Legal Medicine Lausanne-Geneva, University of Lausanne, Rue du Bugnon 21, Lausanne, Switzerland. silke.grabherr@chuv.ch
Silke
S
Grabherr
Francesco
F
Doenz
Beat
B
Steger
Richard
R
Dirnhofer
Alejandro
A
Dominguez
Barbara
B
Sollberger
Erich
E
Gygax
Elena
E
Rizzo
Christine
C
Chevallier
Reto
R
Meuli
Patrice
P
Mangin
D000792:Angiography / Q000379:methods* / Q000592:standards; D001344:Autopsy; D002102:Cadaver; D003287:Contrast Media; D006801:Humans; D011180:Postmortem Changes; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards
D003287:Contrast Media