title: Postmortem computed tomography angiography, contrast medium administration and toxicological analyses in urine.
abstract: Postmortem angiography methods that use water soluble or lipid soluble liquid contrast compounds may potentially modify the composition of fluid-based biological samples and thus influence toxicological findings. In this study, we investigated whether toxicological investigations performed in urine collected prior to and post angiography using Angiofil™ mixed with paraffin oil are characterized by different qualitative or quantitative results. In addition, we studied whether diluting samples with 1% and 3% contrast medium solution may modify molecule concentration. A postmortem angiography group consisting of 50 cases and a postmortem group without angiography consisting of 50 cases were formed. In the first group, toxicological investigations were performed in urine samples collected prior to and post angiography as well as in undiluted and diluted samples. In the second group, analyses were performed in undiluted and diluted urine, bile, gastric content, cerebrospinal and pericardial fluids collected during autopsy. The preliminary results indicate that differences may be observed between urine samples collected prior to and post angiography in the number of identified molecules in relation to specific cases. Analyses performed in diluted samples failed to reveal differences that might potentially alter the interpretation of toxicological results in all analyzed specimens for nearly all molecules, except for tetrahydrocannabinol and its metabolites. Though these findings suggest that toxicology might be effectively performed, in very special cases and for a large number of molecules, in biological samples collected after angiography, it remains recommendable to collect biological fluids for toxicology prior to contrast medium injection.
authors.affiliation: University Centre of Legal Medicine, Lausanne, Switzerland. Electronic address: cristian.palmiere@chuv.ch.
authors.forename: Cristian
authors.initials: C
authors.lastname: Palmiere
authors.affiliation: University Centre of Legal Medicine, Lausanne, Switzerland.
authors.forename: Silke
authors.initials: S
authors.lastname: Grabherr
authors.affiliation: University Centre of Legal Medicine, Lausanne, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Augsburger
mesh_terms: D000792:Angiography / Q000379:methods*; D001344:Autopsy / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage*; D013759:Dronabinol / Q000652:urine; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000652:urine*; D007267:Injections; D008297:Male; D008875:Middle Aged; D009821:Oils / Q000008:administration & dosage; D010232:Paraffin / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D013287:Illicit Drugs; D009821:Oils; D013759:Dronabinol; D010232:Paraffin; C015418:paraffin oils
keywords: Autopsy; Contrast medium; Postmortem computed tomography angiography; Toxicology; Urine