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Computed Tomography: The Revolution in Postmortem Angiography
Title of the book
Atlas of Postmortem Angiography
Springer International Publishing
Multidetector computed tomography (MDCT) is the most widespread tool in modern forensic radiology. Thanks to a short examination time, high spatial resolution, and the possibility of reconstructions in different axes and two and three dimensions, it is an excellent method for rapidly examining a whole body and performing a first analysis of lesions. In clinical radiology, the sensitivity of MDCT can be increased by injecting contrast agent and enhancing the obtained images, leading to better visualization of organ tissues and of the vascular system. This clinical experience inspired researchers in postmortem imaging to start investigating the possibility of performing postmortem MDCT angiography. Similar to the clinical experience, the aim is to increase the sensitivity of postmortem computed tomography (PMCT) and allow investigation of the vascular system, which is often too complex to examine in conventional autopsy, especially if small vessels are to be investigated. However, the application of contrast agent postmortem is challenging and differs from the process in clinical angiography, principally because of the absence of cardiovascular circulation and postmortem changes in the body. Although there are multiple classic methods for performing postmortem angiography, they cannot simply be transferred to modern forensic imaging because they focus primarily on single organs or on embryos and fetuses. Therefore, to overcome these problems, different approaches have been developed for performing modern, minimally invasive PMCT angiography (PMCTA). Once such a technique is established, questions arise about how to interpret the images because they differ from those of clinical angiography. Additionally, the injection of contrast medium into a body that is associated with a medico-legal or forensic investigation implies the problem of eventual alteration of the results or further analyses that are normally performed in such cases. This chapter explains the meaning of PMCTA and the challenges encountered in establishing methods that are applicable in legal medicine; it gives a short overview of the most frequently used techniques in modern forensic imaging.
Postmortem angiography Postmortem computed tomography CT angiography Contrast agent
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