Artifactual aortic dissection as a result of post-mortem CT angiography

Thompson, Corey Evan; Parsons, Sarah; O’Donnell, Chris

doi:10.1016/j.jofri.2016.01.005

Cited by 3 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2016, two more papers and case reports [ 17 , 18 ] were published with angiographies using PEG as a carrier substance. In total, 2500 ml and 1850 ml of fluid were injected to opacify the vessels.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Bruch,

Grabherr,

Bruguier

et al. 2024

Int J Legal Med

View full text Add to dashboard Cite

Computed tomography angiography (PMCTA) is increasingly used in postmortem cases. Standardized validated protocols permit to compare different PMCTA images and make it more easily to defend a case in court. In addition to the well-known technique by Grabherr et al. (2011) which is using paraffin oil as a carrier substance, water-soluble polyethylene glycol 200 (PEG200) can be used in combination with the contrast agent Accupaque® 300. As to date, there exists no standardized protocol for the use of this contrast agent mixture, the aim of this study was to develop a protocol using it. Between 2012 and 2022, 23 PMCTA with PEG200 and Accupaque®300 were performed at the University Centre of Legal Medicine Lausanne (Switzerland) and the Institute of Forensic Medicine Munich (Germany). The images obtained were evaluated regarding the opacification of the vessels and possible artefacts. The best image quality was obtained with a mixing ratio of 1:15 (Accupaque®300:PEG200) and a perfusion volume of 1000 ml in the arterial, 1400 ml in the venous and 350 ml in the dynamic phase. The infusion rates described by Grabherr et al. were confirmed for the three phases. Overall, the opacification of the vessels was diagnostically sufficient. In 13 cases no opacification of the right coronary artery was observed due to a stratification artefact. By using the PMCTA protocol with PEG200 as a carrier, a good overall image quality can be achieved. This protocol offers the possibility to standardize PMCTA with PEG200.

show abstract

Section: Discussionmentioning

confidence: 99%

“…These total injection volumes proved to be too low in comparison with our study material. The published case report by Thompsen et al [ 17 ] showed an aortic dissection, so the small vessels e.g. in the brain were not evaluated.…”

Section: Discussionmentioning

confidence: 99%

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Bruch,

Grabherr,

Bruguier

et al. 2024

Int J Legal Med

View full text Add to dashboard Cite

show abstract

“…Without an angiographic study, the dissection itself is not defined; however, the presence and probable general location of dissection was possible. The success of postmortem angiography in identifying aortic dissection has been reported along with a cautionary case report where dissection was caused by the procedure (5, 6).…”

Section: Discussionmentioning

confidence: 99%

Computed Tomographic Findings in Unsuspected Aortic Dissection and Adult Polycystic Kidney Disease

Harcke¹,

Warren²,

Gordon³

et al. 2016

Academic Forensic Pathology

View full text Add to dashboard Cite

The coexistence of adult polycystic kidney disease and aortic dissection should be recognized by forensic pathologists and radiologists. Two cases with postmortem computed tomography prior to autopsy illustrate the appearance of polycystic kidneys and the hemorrhage patterns that provide clues to the presence and approximate location of the aortic dissections. Optimal imaging technique is discussed.

show abstract

An atypical case of fatal ‘esophageal apoplexy’: post-mortem findings and differential diagnosis

de Boer,

O’Donnell

2024

Int J Legal Med

View full text Add to dashboard Cite

Forensic pathologists need to have comprehensive knowledge of a large variety of causes of sudden natural death. We describe a case of sudden and unexpected death in woman in her sixties due to rupture of a large paraesophageal hematoma. The post-mortem examination and differential diagnosis are discussed. The combined findings of whole-body post-mortem CT imaging (PMCT), targeted PMCT angiography, autopsy, and histology are most in keeping with ‘esophageal apoplexy’; a rare cause of hemorrhage in the esophageal wall. A review of the literature indicates that most cases of esophageal apoplexy are self-limiting and that fatal complications are exceedingly rare. Our case demonstrates that esophageal apoplexy can present as sudden unexpected death.

show abstract

Artifactual aortic dissection as a result of post-mortem CT angiography

Cited by 3 publications

References 20 publications

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography

Computed Tomographic Findings in Unsuspected Aortic Dissection and Adult Polycystic Kidney Disease

An atypical case of fatal ‘esophageal apoplexy’: post-mortem findings and differential diagnosis

Contact Info

Product

Resources

About