title: Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.forename: Christine
authors.initials: C
authors.lastname: Chevallier
authors.affiliation: University Centre of Legal Medicine Lausanne-Geneva, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland. christine.chevallier@chuv.ch
authors.forename: Chevallier
authors.initials: C
authors.lastname: Christine
authors.forename: Francesco
authors.initials: F
authors.lastname: Doenz
authors.forename: Doenz
authors.initials: D
authors.lastname: Francesco
authors.forename: Paul
authors.initials: P
authors.lastname: Vaucher
authors.forename: Vaucher
authors.initials: V
authors.lastname: Paul
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
authors.forename: Palmiere
authors.initials: P
authors.lastname: Cristian
authors.forename: Alejandro
authors.initials: A
authors.lastname: Dominguez
authors.forename: Dominguez
authors.initials: D
authors.lastname: Alejandro
authors.forename: Stefano
authors.initials: S
authors.lastname: Binaghi
authors.forename: Binaghi
authors.initials: B
authors.lastname: Stefano
authors.forename: Patrice
authors.initials: P
authors.lastname: Mangin
authors.forename: Mangin
authors.initials: M
authors.lastname: Patrice
authors.forename: Silke
authors.initials: S
authors.lastname: Grabherr
authors.forename: Grabherr
authors.initials: G
authors.lastname: Silke
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001344:Autopsy; D001808:Blood Vessels / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology; D002423:Cause of Death; D003287:Contrast Media; D005260:Female; D049429:Forensic Pathology / Q000379:methods; D050723:Fractures, Bone / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media