The use of contrast-enhanced post Mortem CT in the detection of cardiovascular deaths.
OBJECTIVE
To evaluate the diagnostic value of contrast enhanced post mortem computed tomography (PMCT) in comparison to non-enhanced post mortem CT in the detection of cardiovascular causes of death (COD).


BACKGROUND
As autopsy rates decline, new methods to determine CODs are necessary. So contrast enhanced PMCT shall be evaluated in comparison to established non-enhanced PMCT in order to further improve the method.


METHODS
In a prospective study, 20 corpses were examined using a 64-row multisclice CT (MSCT) before and after intraarterial perfusion with a newly developed, barium-bearing contrast agent and ventilation of the lungs. The cause of death was determined in enhanced and unenhanced scans and a level of confidence (LOC) was given by three experienced radiologists on a scale between 0 and 4. Results were compared to autopsy results as gold standard. Autopsy was performed blinded to PMCT-findings.


RESULTS
The method allowed visualization of different types of cause of death. There was a significant improvement in LOC in enhanced scans compared to unenhanced scans as well as an improvement in the detection of COD. The cause of death could be determined in 19 out of 20 patients.


CONCLUSIONS
PMCT is feasible and appears to be robust for diagnosing cardiovascular causes of death. When compared with unenhanced post-mortem CT intraarterial perfusion and pulmonary ventilation significantly improve visualization and diagnostic accuracy. These promising results warrant further studies.
Department of Diagnostic and Interventional Radiology, Philipps University Hospital Marburg, Marburg, Germany.
Jonas Christoph
JC
Apitzsch
Department of Pathology, RWTH Aachen University Hospital, Aachen, Germany.
Saskia
S
Westphal
Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany; Department of Diagnostic and Interventional Radiology, RWTH-Aachen University Hospital, Aachen, Germany.
Tobias
T
Penzkofer
Department of Diagnostic and Interventional Radiology, RWTH-Aachen University Hospital, Aachen, Germany.
Christiane Katharina
CK
Kuhl
Department of Pathology, RWTH Aachen University Hospital, Aachen, Germany.
Ruth
R
Knüchel
Department of Diagnostic and Interventional Radiology, RWTH-Aachen University Hospital, Aachen, Germany.
Andreas H
AH
Mahnken
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy / Q000379:methods*; D002102:Cadaver; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D002423:Cause of Death; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media