title: Postmortem dynamic cerebral angiography for detecting aneurysm and bleeding sites in cases of subarachnoid hemorrhage.
abstract: One of the advantages of postmortem imaging is its ability to obtain diagnostic findings in a non-destructive manner when autopsy is either difficult or may destroy forensic evidence. In recent years, efforts have been made to incorporate computed tomography (CT) based postmortem angiography into forensic pathology; however, it is not currently clear how well the modality can determine sites of bleeding in cases of subarachnoid hemorrhage. Therefore, in this study, we investigated the utility of postmortem cerebral angiography using multi-detector row CT (MDCT) by injecting a contrast medium through a catheter inserted into the internal carotid and vertebral arteries of 10 subarachnoid hemorrhage cases. While postmortem MDCT angiography (PMCTA) was capable of detecting aneurysms in a non-destructive manner, it was sometimes difficult to identify the aneurysm and bleeding sites because of a large amount of contrast medium leaking into the extravascular space. To overcome this problem, we developed the novel contrast imaging method "dynamic cerebral angiography," which involves scanning the same area multiple times while injecting contrast medium to enable real-time observation of the contrasted vasculature. Using multiphase contrast images acquired by this method, we successfully captured the moment when contrast medium leaked from the hemorrhage site. This method will be useful for identifying exact bleeding sites on PMCTA.
authors: Departments of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan, goinokuchi@chiba-u.jp.
authors: Go
authors: G
authors: Inokuchi
authors: Daisuke
authors: D
authors: Yajima
authors: Mutsumi
authors: M
authors: Hayakawa
authors: Ayumi
authors: A
authors: Motomura
authors: Fumiko
authors: F
authors: Chiba
authors: Suguru
authors: S
authors: Torimitsu
authors: Yohsuke
authors: Y
authors: Makino
authors: Hirotaro
authors: H
authors: Iwase
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D002533:Cerebral Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology; D007472:Iohexol / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D020206:Subarachnoid Hemorrhage, Traumatic / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media; D007472:Iohexol