title: Postmortem CT angiography: capabilities and limitations in traumatic and natural causes of death.
abstract: Whole-body postmortem computed tomographic (CT) angiography is a promising new development in forensic radiology that has the potential to improve vascular and soft-tissue imaging beyond levels currently achievable with unenhanced postmortem CT. Postmortem access to the vascular system and injection of contrast medium are different from those steps in clinical (antemortem) radiology. Because there is no circulation in a corpse that could transport or dilute a contrast medium, the injection must be performed by using a roller pump to fill the vasculature (arterial and venous) with a mixture of a water-soluble iodized contrast medium and polyethylene glycol. In contrast to a classic autopsy, postmortem CT angiography is a minimally invasive procedure. It allows the diagnosis of vascular lesions without the disruption or destruction of anatomic structures, which could result in a loss of evidence in a criminal investigation. Furthermore, postmortem CT angiography facilitates the display of vascular pathologic conditions in areas that are not typically covered with autopsy alone, such as the craniocervical junction and the small pelvis. Therefore, postmortem CT angiography adds substantial value to the classic forensic autopsy; cross-sectional data can be reevaluated objectively at any time and are fully reproducible as counterexpertise, which is as useful in the fields of forensic medicine and pathology as in clinical research. Familiarity with the capabilities of postmortem CT angiography may help radiologists working with forensic cases improve their diagnostic performance.
authors.affiliation: From the Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland (S.G.R., S.A.B., G.A., M.J.T., P.M.F.); the Institute of Forensic Medicine, University of Berne, Berne, Switzerland (S.G.R.); the Institute of Forensic Medicine, University of Berlin, Berlin, Germany (L.O.); and the Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland (P.M.F.).
authors.forename: Steffen G
authors.initials: SG
authors.lastname: Ross
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Bolliger
authors.forename: Garyfalia
authors.initials: G
authors.lastname: Ampanozi
authors.forename: Lars
authors.initials: L
authors.lastname: Oesterhelweg
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Flach
mesh_terms: D000792:Angiography / Q000379:methods*; D001344:Autopsy; D001777:Blood Coagulation; D002423:Cause of Death; D003287:Contrast Media; D003933:Diagnosis; D005554:Forensic Medicine / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006355:Heart-Lung Machine; D006801:Humans; D007260:Infusion Pumps; D011180:Postmortem Changes; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*; D057772:Vascular System Injuries / Q000000981:diagnostic imaging; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media