title: Multi-phase post-mortem CT-angiography: a pathologic correlation study on cardiovascular sudden death.
abstract: Multi-phase post-mortem CT-angiography (MPMCTA) has the great potential to increase the quality of the post-mortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation (Vitrea) and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease.
authors.affiliation: Section of Forensic Pathology, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Turillazzi
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Frati
authors.affiliation: Section of Forensic Pathology, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
authors.forename: Natascha
authors.initials: N
authors.lastname: Pascale
authors.affiliation: Section of Forensic Pathology, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; Department of Anatomy, University of Malta, Malta.
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Pomara
authors.affiliation: Operative Unit of Radiodiagnostics, Ospedali Riuniti, Foggia, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Grilli
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
authors.forename: Rocco Valerio
authors.initials: RV
authors.lastname: Viola
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Fineschi
keywords: Angiography; Imaging; Sudden death