Modified whole-body postmortem computed tomography angiography using neck approach

Abstract

Background: The use of radiologic imaging methods in postmortem practice has been advent since the discovery of X-rays. However, with advancement in technology and the emergence of multi-detector computed tomography (MDCT), computed tomography angiography (CTA) and magnetic resonance imaging (MRI) in clinical radiology, several centers around the world have begun using these methods as an adjunct to conventional autopsy. The aim of this study is to introduce a modified protocol for whole-body postmortem computed tomography angiography (PMCTA) based on body weight and neck approach as an alternative to the different PMCTA approaches currently available as most previous studies concentrated on the use of femoral approach for whole-body PMCTA with neck approach for selective or targeted PMCTA. Methods: This was a prospective, double-blinded, cross-sectional study performed on 60 subjects with a mean age of 45.6 years and weight ranging between 43 and 112 kg utilizing ionized water-soluble contrast medium mixed with polyethylene glycol (polyethylene glycol 200). Results: PMCTA using neck dissection showed promising results with good image quality and diagnostic capabilities assisting the forensic pathologists in determining the final cause of death with a strong correlation between both radiologists and pathologists in 86.7% of cases. Conclusions: This study showed that the modified infusion protocol based on body weight using the neck approach provided a good depiction of the vascular system down to the level of the small supplying vessels similar to the other different approaches for PMCTA.