Whole-body post-mortem computed tomography angiography of a newborn revealing transposition of great arteries

The number of medico-legal post-mortem examinations referring to newborns is considerably low: In the case of the Chair and Department of Forensic Medicine of the author’s origin, the autopsy rate of such cases is less than 1 %. Even experienced forensic pathologists can find the technical autopsy procedure of a newborn quite difficult. Post-mortem imaging using unenhanced post-mortem computed tomography (PMCT) gives only a limited opportunity to help in conventional autopsy examination. By adding contrast medium (CA) administration, we can significantly expand diagnostic capabilities. However, the post-mortem computed tomography angiography (PMCTA) technique has already been developed mostly in adult death cases (as considerably much more frequent), and no standardised protocol for examination of children exists. The authors present the dual-phase PMCTA examination of a newborn by manual CA administration using the access to umbilical vessels (vein and artery) unveiling transposition of the great arteries (TGA). The results are presented as multiplanar reformatted (MPR) images and three-dimensional (3D) images by volume/surface-rendered reconstructions, giving a contribution towards proving the value of forensic imaging in post-mortem examinations of heart and vascular malformations in newborns.