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Evaluation of postmortem MDCT and MDCT-angiography for the investigation of sudden cardiac death related to atherosclerotic coronary artery disease

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Abstract

The goal of this study was to evaluate the diagnostic value of postmortem multi-computed tomography (MDCT) and MDCT-angiography for sudden cardiac deaths related to ischemic heart disease. Twenty three cases were selected based on clinical history and the results of native MDCT, multiphase post-mortem CT-angiography and conventional autopsy were compared. Radiological examination showed calcification of coronary arteries in 78% of the cases, most of which were not detailed at autopsy. MDCT-angiography allowed better visualization of the coronary arteries than MDCT and permitted the evaluation of stenoses and occlusions. Of the 14 cases of coronary thrombosis detected at conventional autopsy, 11 were visible as stop of perfusion with CT-angiography and three were found to be partly perfused. One case had an old thrombosis with collateral circulation. One case had a coronary artery postmortem clot found with MDCT-angiography. Coronary artery calcifications are more easily detected and documented with radiological examination than with conventional autopsy. MDCT is of limited diagnostic value for ischemic heart disease. MDCT-angiography, when correctly interpreted, is a reasonable tool to view the morphology of coronary arteries, rule out significant coronary artery stenoses, identify occlusions and direct sampling for histological examination.

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Acknowledgments

This study was partly financially supported by the Promotion Agency for Innovation of the Swiss Confederation (KTI Nr.10221.1 PFIW-IW). We thank the team of the unity of forensic medicine in Lausanne for their assistance and Allison Felley Jacquemont for editing the manuscript.

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Authors and Affiliations

  1. University Center of Legal Medicine Lausanne—Geneva, Lausanne, Switzerland

    Katarzyna Michaud, Silke Grabherr & Patrice Mangin

  2. Centre universitaire de médicine légale, CHUV—University of Lausanne, Rue du Bugnon 21, 1010, Lausanne, Switzerland

    Katarzyna Michaud, Silke Grabherr & Patrice Mangin

  3. Department of Diagnostic and Interventional Radiology, CHUV—University of Lausanne, Rue du Bugnon 46, Lausanne, Switzerland

    Francesco Doenz

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  1. Katarzyna Michaud
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  2. Silke Grabherr
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Correspondence to Katarzyna Michaud.

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Michaud, K., Grabherr, S., Doenz, F. et al. Evaluation of postmortem MDCT and MDCT-angiography for the investigation of sudden cardiac death related to atherosclerotic coronary artery disease. Int J Cardiovasc Imaging 28, 1807–1822 (2012). https://doi.org/10.1007/s10554-012-0012-x

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  • DOI: https://doi.org/10.1007/s10554-012-0012-x

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