Usefulness of coronary postmortem computed tomography angiography to detect lesions in the coronary artery and myocardium in cases of sudden death

Takei, Hiroyuki; Sano, Rie; Takahashi, Yōichirō; Takahashi, Keiko; Kominato, Yoshihiko; Tokue, Hiroyuki; Shimada, Takahiro; Awata, Sachiko; Hirasawa, Satoshi; Ohta, Naoya

doi:10.1016/j.legalmed.2017.11.005

Cited by 12 publications

(16 citation statements)

References 25 publications

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“…Occlusive lesions related to stent implantation are an important pathological condition [16], although postmortem evaluation of such lesions is often difficult because histopathological examination of the artery is significantly limited due to the presence of the metal stent. We have previously reported the usefulness of targeted PMCTA for evaluation of coronary lesions such as coronary artery stenosis or anomalous aortic origin of the coronary artery [7,17], but arteries that have been subjected to stent implantation have not been evaluated. Since TOC would also be useful for evaluation of arterial occlusion, we investigated the stent-implanted artery using conventional PMCTA, improved PMCTA with micro-CT, and TOC.…”

Section: Tissue Optical Clearing As a Novel Methods For Visualizing T...mentioning

confidence: 99%

“…Targeted PMCTA was performed as reported previously [7,17], except that the barium concentration in the contrast medium was reduced to about 6% (w/v) to avoid extremely high absorption in CT images. Subsequent X-ray exposure was performed using a sixteenslice CT scanner (Alexion/TSX-034A, Toshiba) with the following scan parameters: field of view 18 cm, collimation 0.5 mm, reconstruction interval 0.5 mm, 120 kVp, 150 mA, 0.75 s/rotation, and pitch factor 0.75.…”

Section: Targeted Postmortem Ct Angiography (Pmcta)mentioning

confidence: 99%

“…In this context, postmortem computed tomography (PMCT) is an available option for reducing the risk of missing small lesions. However, even PMCT with millimeter-scale spatial resolution could potentially miss important lesions [5,6], unless supportive countermeasures including target angiography are employed [7][8][9][10]. Therefore, alternative or additional techniques have been required to facilitate practical screening of the body or organs for the presence of small lesions.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of a tissue optical clearing technique for forensic autopsy

Takahashi

Hayakawa

Sano

et al. 2022

Journal of Forensic Sciences

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Forensic pathologists are required to investigate lethal trauma or disease at autopsy. In addition to massive contusions of various organs, a number of small features with potentially fatal implications also need to be sought. Since such lesions may need microscopic examinations for detailed evaluation, it is important to select suitable anatomic locations for tissue sampling. For practical screening of small lesions, we have developed a tissue optical clearing (TOC) technique for forensic autopsy. The technique involves clearing with a non‐toxic organic solvent, ethyl cinnamate, which renders excised organs transparent, while hemorrhages or blood‐containing vessels remain opaque. Using this technique, tiny hemorrhages in the spinal cord were able to be identified by gross examination, allowing proper selection of locations for tissue sampling. Subsequent histopathological evaluation was successfully performed with no apparent artifacts related with the TOC procedure. In addition, a combination of TOC and targeted CT angiography allowed feasible examination of the arterial occlusive lesion in the superior mesenteric artery, and when combined with micro‐CT scanning it was useful for evaluating the lumen of the coronary artery with stent implantation. The results obtained so far indicated that TOC could complement routine forensic autopsy procedures when detailed evaluation of small lesions is required.

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Section: Tissue Optical Clearing As a Novel Methods For Visualizing T...mentioning

confidence: 99%

Section: Targeted Postmortem Ct Angiography (Pmcta)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usefulness of a tissue optical clearing technique for forensic autopsy

Takahashi

Hayakawa

Sano

et al. 2022

Journal of Forensic Sciences

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“…In this regard, a recent study has used myocardial perfusion scintigraphy to determine myocardial perfusion extent as an indicator of CAD DOI:10.15171/ipp.2020.12 severity (9); however, the gold standard is the conventional coronary angiography (CA) which visualizes the anatomy of coronary vessels (10) . It is noteworthy that CA, despite being invasive, is the preferable method because unlike the scintigraphy approach, it reveals the exact anatomy of coronary arteries (11). Likewise, SYNTAX (SX) score was introduced in the SYNTAX study (SYNergy between PCI with TAXus TM and cardiac surgery) as a useful index that scores lesion severity and complexity during CA, while, is hypothesized to be able to predict the prognosis too (12).…”

Section: Key Pointmentioning

confidence: 99%

Serum parameters and severity of coronary artery disease in patients with acute coronary syndrome

et al. 2020

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Introduction: Coronary artery disease (CAD) is one of the most common causes of morbidity and mortality in developed countries. SYNTAX (SX) score is a useful index that scores lesion severity during coronary angiography (CA) and can predict the patient’s outcome. Recent studies have associated a number of serum parameters with SX score, including platelet volume, and platelet-to-lymphocyte ratio (PLR). Objectives: We aimed to study the SX score in association with various serum parameters to find a valuable parameter for prediction of CAD severity. Patients and Methods: This study consisted of 363 patients referred to Heshmat hospital (Rasht) from March 2016 to October 2016 with acute coronary syndrome (ACS). Serum laboratory parameters were measured after 12 hours of fasting. Severity of CAD was evaluated during CA by SX score. The associations were analyzed using multinomial logistic regression model. Results: The mean age of patients was 63.68±11.03 years; since 26.2% of cases had severe, 43% had moderate, and 30.8% had mild CAD. Comparing to mild CAD, the multivariate adjusted model showed higher significant odds of severe CAD for one elevation of platelets (odds ratio [OR] =2.18 (95% CI: 1.35-3.50), white blood cells (WBCs) (OR=1.66, 95% CI: 1.17-2.35) RDW (red cell distribution width), (OR=1.59, 95% CI: 1.08-2.35) and serum creatinine (OR=1.75, 95% CI: 1.16-2.63). Conclusion: Plasma platelets, WBC and RDW and also serum creatinine were all independently correlated with severity of CAD.

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“…Post-mortem computed tomographic Angiography (PMCTA) is a relative new modality used to detect coronary atherosclerosis as a non-invasive tool [2,3]. The main limitation in PMCTA is the spatial resolution and the fact that calcified plaque is overestimated [4].…”

Section: Introductionmentioning

confidence: 99%