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International Journal of Legal Medicine

, Volume 127, Issue 5, pp 981–989 | Cite as

Postmortem computed tomography angiography vs. conventional autopsy: advantages and inconveniences of each method

  • Chevallier Christine
  • Doenz Francesco
  • Vaucher Paul
  • Palmiere Cristian
  • Dominguez Alejandro
  • Binaghi Stefano
  • Mangin Patrice
  • Grabherr Silke
Original Article

Abstract

Purpose

Postmortem computed tomography angiography (PMCTA) was introduced into forensic investigations a few years ago. It provides reliable images that can be consulted at any time. Conventional autopsy remains the reference standard for defining the cause of death, but provides only limited possibility of a second examination. This study compares these two procedures and discusses findings that can be detected exclusively using each method.

Materials and methods

This retrospective study compared radiological reports from PMCTA to reports from conventional autopsy for 50 forensic autopsy cases. Reported findings from autopsy and PMCTA were extracted and compared to each other. PMCTA was performed using a modified heart–lung machine and the oily contrast agent Angiofil® (Fumedica AG, Muri, Switzerland).

Results

PMCTA and conventional autopsy would have drawn similar conclusions regarding causes of death. Nearly 60 % of all findings were visualized with both techniques. PMCTA demonstrates a higher sensitivity for identifying skeletal and vascular lesions. However, vascular occlusions due to postmortem blood clots could be falsely assumed to be vascular lesions. In contrast, conventional autopsy does not detect all bone fractures or the exact source of bleeding. Conventional autopsy provides important information about organ morphology and remains the only way to diagnose a vital vascular occlusion with certitude.

Conclusion

Overall, PMCTA and conventional autopsy provide comparable findings. However, each technique presents advantages and disadvantages for detecting specific findings. To correctly interpret findings and clearly define the indications for PMCTA, these differences must be understood.

Keywords

Forensic medicine X-Ray computed tomography Autopsy Perfusion imaging Angiography 

Notes

Acknowledgments

This study was financially supported by the Promotion Agency for Innovation of the Swiss Confederation (KTI Nr.10221.1 PFIW-IW) and the Leenards Foundation, Lausanne, Switzerland.

Conflicts of interest

None

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Chevallier Christine
    • 1
    • 2
  • Doenz Francesco
    • 2
  • Vaucher Paul
    • 3
  • Palmiere Cristian
    • 1
  • Dominguez Alejandro
    • 1
    • 4
  • Binaghi Stefano
    • 2
  • Mangin Patrice
    • 1
    • 3
  • Grabherr Silke
    • 1
  1. 1.University Centre of Legal Medicine Lausanne–GenevaUniversity of LausanneLausanneSwitzerland
  2. 2.Department of Diagnostic and Interventional RadiologyUniversity Hospital of LausanneLausanneSwitzerland
  3. 3.University Centre of Legal Medicine Lausanne–GenevaUniversity of GenevaGeneva 4Switzerland
  4. 4.University of Health Sciences (HESAV)LausanneSwitzerland

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