Postmortem computed tomography angiography, contrast medium administration and toxicological analyses in urine

Palmière, Cristian; Grabherr, Silke; Augsburger, Marc

doi:10.1016/j.legalmed.2014.12.005

Cited by 15 publications

(4 citation statements)

References 10 publications

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“…In a polytrauma situation, for example, when a forensic diagnosis of vitality of the trauma is required, CT-guided pulmonary tissue sampling using clinical biopsy needles can be performed before the injection of the oily contrast agent to allow reliable histological samples [ 49 , 62 ]. It is recommended to allow microbiological and toxicological analysis samples to be taken with or without CT-guidance prior to the injection of the contrast agent [ 63 , 64 ].…”

Section: The Methodsmentioning

confidence: 99%

Modern post-mortem imaging: an update on recent developments

Grabherr

Egger

Vilarino

et al. 2017

Forensic Sciences Research

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Modern post-mortem investigations use an increasing number of digital imaging methods, which can be collected under the term “post-mortem imaging”. Most methods of forensic imaging are from the radiology field and are therefore techniques that show the interior of the body with technologies such as X-ray or magnetic resonance imaging. To digitally image the surface of the body, other techniques are regularly applied, e.g. three-dimensional (3D) surface scanning (3DSS) or photogrammetry. Today's most frequently used techniques include post-mortem computed tomography (PMCT), post-mortem magnetic resonance imaging (PMMR), post-mortem computed tomographic angiography (PMCTA) and 3DSS or photogrammetry. Each of these methods has specific advantages and limitations. Therefore, the indications for using each method are different. While PMCT gives a rapid overview of the interior of the body and depicts the skeletal system and radiopaque foreign bodies, PMMR allows investigation of soft tissues and parenchymal organs. PMCTA is the method of choice for viewing the vascular system and detecting sources of bleeding. However, none of those radiological methods allow a detailed digital view of the body's surface, which makes 3DSS the best choice for such a purpose. If 3D surface scanners are not available, photogrammetry is an alternative. This review article gives an overview of different imaging techniques and explains their applications, advantages and limitations. We hope it will improve understanding of the methods.

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Section: The Methodsmentioning

confidence: 99%

Modern post-mortem imaging: an update on recent developments

Grabherr

Egger

Vilarino

et al. 2017

Forensic Sciences Research

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“…39 This approach is particularly important when no autopsy can be performed or when post-mortem angiography is carried out, since samples must be collected prior to the injection of contrast medium in order to avoid contamination. 41 Minimally invasive puncture also enables the controlled collection of gas samples, which is only possible to a limited extent during autopsy. As mentioned above, MDCT is an excellent tool for detecting even the smallest gas accumulations.…”

Section: Pmct-guided Samplingmentioning

confidence: 99%

Post-mortem imaging in forensic investigations: current utility, limitations, and ongoing developments

Grabherr¹,

Baumann²,

Minoiu³

et al. 2016

RRFMS

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Forensic imaging is a new field with increasing application all over the world. However, its role in legal medicine is controversial, mostly due to the use of undefined and unclear terms. The aim of this article is to describe forensic imaging and to explain the various techniques that pertain to it. Essentially, these methods consist of radiological methods such as conventional radiography, computed tomography, and magnetic resonance imaging, but other techniques such as 3D surface scanning are also employed. Computed tomography can be combined with minimally invasive strategies such as image-guided sampling or post-mortem angiography. We provide an overview of the advantages and limitations of these methods, which must be identified and understood to enable correct application.

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“…Only a few studies have investigated the influence of different contrast media. The available studies pertain exclusively to MPMCTA and TCA and their influence on toxicology [41,42], biochemistry [43], microbiology [44], genetics [45], histology, and fatty embolism evaluation [46,47]. Therefore, the recommendation remains that as many specimens as possible should be sampled prior to injection of the contrast medium, as described by Schneider et al [48].…”

Section: Oily Contrast Agent Mixturementioning

confidence: 99%

Application of contrast media in post-mortem imaging (CT and MRI)

et al. 2015

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The application of contrast media in post-mortem radiology differs from clinical approaches in living patients. Post-mortem changes in the vascular system and the absence of blood flow lead to specific problems that have to be considered for the performance of post-mortem angiography. In addition, interpreting the images is challenging due to technique-related and post-mortem artefacts that have to be known and that are specific for each applied technique. Although the idea of injecting contrast media is old, classic methods are not simply transferable to modern radiological techniques in forensic medicine, as they are mostly dedicated to single-organ studies or applicable only shortly after death. With the introduction of modern imaging techniques, such as post-mortem computed tomography (PMCT) and post-mortem magnetic resonance (PMMR), to forensic death investigations, intensive research started to explore their advantages and limitations compared to conventional autopsy. PMCT has already become a routine investigation in several centres, and different techniques have been developed to better visualise the vascular system and organ parenchyma in PMCT. In contrast, the use of PMMR is still limited due to practical issues, and research is now starting in the field of PMMR angiography. This article gives an overview of the problems in post-mortem contrast media application, the various classic and modern techniques, and the issues to consider by using different media.

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Postmortem computed tomography angiography, contrast medium administration and toxicological analyses in urine

Cited by 15 publications

References 10 publications

Modern post-mortem imaging: an update on recent developments

Modern post-mortem imaging: an update on recent developments

Post-mortem imaging in forensic investigations: current utility, limitations, and ongoing developments

Application of contrast media in post-mortem imaging (CT and MRI)

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