title: Visualization of myocardial infarction by post-mortem single-organ coronary computed tomography: a feasibility study.
abstract: BACKGROUND
  Post-mortem imaging is increasingly used in forensic field in cases of natural deaths related to cardiovascular diseases, which represent the most common causes of death in developed countries. While radiological examination is generally considered to be a good complement for conventional autopsy, it was thought to have limited application in cardiovascular pathology. The aim of this study was to investigate the role of post-mortem multidetector coronary artery computed tomography in cases of sudden death in adults.
  
  
  METHODS
  We have enrolled 11 cases, all of whom were negative for macroscopic extra-cardiac lethal findings after standard autopsy procedure. Later, from the same individuals, isolated single-organ post-mortem computed tomography coronarography (PMCTA), using an iodinated non-ionic contrast medium, was achieved. After computed tomography examination, all the isolated hearths were carried to the forensic pathologist, and a conventional histology assessment was performed on them.
  
  
  RESULTS
  In 7 out of 11 of cadavers, a final diagnosis of myocardial infarction was made after a complete autopsy and histology procedures. Isolated hearts underwent PMCTA scanning and was confirmed in 6/11 cases, with the autopsy findings showing the presence and the localization of occlusions or severe stenoses and the extension of the myocardial hypoxic area by the extravasation of contrast medium as well.
  
  
  CONCLUSIONS
  Isolated single-organ PMCTA could be considered a valid and useful tool in addition to traditional autopsy investigation (macroscopic sections and histology) in identifying the cause of death by recognizing the presence and degree of coronary artery disease and myocardial infarction area visualization.
authors.affiliation: Institute of Public Health, Section of Legal Medicine, Catholic University, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Polacco
authors.forename: Pietro
authors.initials: P
authors.lastname: Sedati
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Arena
authors.forename: Vincenzo L
authors.initials: VL
authors.lastname: Pascali
authors.forename: Bruno Beomonte
authors.initials: BB
authors.lastname: Zobel
authors.forename: Antonio
authors.initials: A
authors.lastname: Oliva
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rossi
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology; D016757:Death, Sudden, Cardiac / Q000473:pathology*; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009203:Myocardial Infarction / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000473:pathology; D009206:Myocardium / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity