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Myocardial Contrast Defect Associated with Thrombotic Coronary Occlusion: Pre-Autopsy Diagnosis of a Cardiac Death with Post-Mortem CT Angiography

  • Lee, Heon (Department of Radiology, Soonchunhyang University Hospital) ;
  • Park, Hyejin (Department of Forensic Medicine, National Forensic Service) ;
  • Cha, Jang Gyu (Department of Radiology, Soonchunhyang University Hospital) ;
  • Lee, Sookyoung (Department of Forensic Medicine, National Forensic Service) ;
  • Yang, Kyungmoo (Department of Forensic Medicine, National Forensic Service)
  • Received : 2015.03.17
  • Accepted : 2015.06.10
  • Published : 2015.09.01

Abstract

We report the case of a female who died of suspected acute myocardial infarction. Post-mortem CT angiography (PMCTA) was performed with intravascular contrast infusion before the standard autopsy, and it successfully demonstrated the complete thrombotic occlusion of a coronary artery and also a corresponding perfusion defect on myocardium. We herein describe the PMCTA findings of a cardiac death with special emphasis on the potential benefits of this novel CT technique in forensic practice.

Keywords

References

  1. Bastarrika G, Lee YS, Huda W, Ruzsics B, Costello P, Schoepf UJ. CT of coronary artery disease. Radiology 2009;253:317-338 https://doi.org/10.1148/radiol.2532081738
  2. Leth PM. Computerized tomography used as a routine procedure at postmortem investigations. Am J Forensic Med Pathol 2009;30:219-222 https://doi.org/10.1097/PAF.0b013e318187e0af
  3. Dirnhofer R, Jackowski C, Vock P, Potter K, Thali MJ. VIRTOPSY: minimally invasive, imaging-guided virtual autopsy. Radiographics 2006;26:1305-1333 https://doi.org/10.1148/rg.265065001
  4. Grabherr S, Djonov V, Yen K, Thali MJ, Dirnhofer R. Postmortem angiography: review of former and current methods. AJR Am J Roentgenol 2007;188:832-838 https://doi.org/10.2214/AJR.06.0787
  5. Grabherr S, Doenz F, Steger B, Dirnhofer R, Dominguez A, Sollberger B, et al. Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Legal Med 2011;125:791-802 https://doi.org/10.1007/s00414-010-0526-5
  6. Michaud K, Grabherr S, Doenz F, Mangin P. Evaluation of postmortem MDCT and MDCT-angiography for the investigation of sudden cardiac death related to atherosclerotic coronary artery disease. Int J Cardiovasc Imaging 2012;28:1807-1822 https://doi.org/10.1007/s10554-012-0012-x
  7. Roberts IS, Benamore RE, Peebles C, Roobottom C, Traill ZC. Technical report: diagnosis of coronary artery disease using minimally invasive autopsy: evaluation of a novel method of post-mortem coronary CT angiography. Clin Radiol 2011;66:645-650 https://doi.org/10.1016/j.crad.2011.01.007
  8. Saunders SL, Morgan B, Raj V, Robinson CE, Rutty GN. Targeted post-mortem computed tomography cardiac angiography: proof of concept. Int J Legal Med 2011;125:609-616 https://doi.org/10.1007/s00414-011-0559-4
  9. Morgan B, Sakamoto N, Shiotami S, Grabherr S. Postmortem computed tomography (PMCT) scanning with angiography (PMCTA): a description of three distinct Methods. In: Rutty GN, ed. Essentials of autopsy practice, 1st ed. London: Springer-Verlag, 2014:1-21
  10. Grabherr S, Hess A, Karolczak M, Thali MJ, Friess SD, Kalender WA, et al. Angiofil-mediated visualization of the vascular system by microcomputed tomography: a feasibility study. Microsc Res Tech 2008;71:551-556 https://doi.org/10.1002/jemt.20585

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