Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method

被引:76
作者
Christine, Chevallier [1 ,2 ]
Francesco, Doenz [2 ]
Paul, Vaucher [3 ]
Cristian, Palmiere [1 ]
Alejandro, Dominguez [1 ,4 ]
Stefano, Binaghi [2 ]
Patrice, Mangin [1 ,3 ]
Silke, Grabherr [1 ]
机构
[1] Univ Lausanne, Univ Ctr Legal Med Lausanne Geneva, CH-1011 Lausanne, Switzerland
[2] Univ Lausanne Hosp, Dept Diagnost & Intervent Radiol, CH-1011 Lausanne, Switzerland
[3] Univ Geneva, Univ Ctr Legal Med Lausanne Geneva, CH-2011 Geneva 4, Switzerland
[4] Univ Hlth Sci HESAV, CH-1011 Lausanne, Switzerland
关键词
Forensic medicine; X-Ray computed tomography; Autopsy; Perfusion imaging; Angiography; MINIMALLY INVASIVE AUTOPSY; DIAGNOSIS; VIRTOPSY; MDCT;
D O I
10.1007/s00414-012-0814-3
中图分类号
DF [法律]; D9 [法律]; R [医药、卫生];
学科分类号
0301 ; 10 ;
摘要
Postmortem computed tomography angiography (PMCTA) was introduced into forensic investigations a few years ago. It provides reliable images that can be consulted at any time. Conventional autopsy remains the reference standard for defining the cause of death, but provides only limited possibility of a second examination. This study compares these two procedures and discusses findings that can be detected exclusively using each method. This retrospective study compared radiological reports from PMCTA to reports from conventional autopsy for 50 forensic autopsy cases. Reported findings from autopsy and PMCTA were extracted and compared to each other. PMCTA was performed using a modified heart-lung machine and the oily contrast agent AngiofilA (R) (Fumedica AG, Muri, Switzerland). PMCTA and conventional autopsy would have drawn similar conclusions regarding causes of death. Nearly 60 % of all findings were visualized with both techniques. PMCTA demonstrates a higher sensitivity for identifying skeletal and vascular lesions. However, vascular occlusions due to postmortem blood clots could be falsely assumed to be vascular lesions. In contrast, conventional autopsy does not detect all bone fractures or the exact source of bleeding. Conventional autopsy provides important information about organ morphology and remains the only way to diagnose a vital vascular occlusion with certitude. Overall, PMCTA and conventional autopsy provide comparable findings. However, each technique presents advantages and disadvantages for detecting specific findings. To correctly interpret findings and clearly define the indications for PMCTA, these differences must be understood.
引用
收藏
页码:981 / 989
页数:9
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