Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_D82AB53ECCF9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Development of a protocol for standardized use of a water-soluble contrast agent with polyethylene glycol in post-mortem CT angiography.
Journal
International journal of legal medicine
Author(s)
Bruch G.M., Grabherr S., Bruguier C., Fischer F.T., Soto R., Magnin V., Genet P.
ISSN
1437-1596 (Electronic)
ISSN-L
0937-9827
Publication state
Published
Issued date
07/2024
Peer-reviewed
Oui
Volume
138
Number
4
Pages
1437-1446
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Computed tomography angiography (PMCTA) is increasingly used in postmortem cases. Standardized validated protocols permit to compare different PMCTA images and make it more easily to defend a case in court. In addition to the well-known technique by Grabherr et al. (2011) which is using paraffin oil as a carrier substance, water-soluble polyethylene glycol 200 (PEG200) can be used in combination with the contrast agent Accupaque® 300. As to date, there exists no standardized protocol for the use of this contrast agent mixture, the aim of this study was to develop a protocol using it. Between 2012 and 2022, 23 PMCTA with PEG200 and Accupaque®300 were performed at the University Centre of Legal Medicine Lausanne (Switzerland) and the Institute of Forensic Medicine Munich (Germany). The images obtained were evaluated regarding the opacification of the vessels and possible artefacts. The best image quality was obtained with a mixing ratio of 1:15 (Accupaque®300:PEG200) and a perfusion volume of 1000 ml in the arterial, 1400 ml in the venous and 350 ml in the dynamic phase. The infusion rates described by Grabherr et al. were confirmed for the three phases. Overall, the opacification of the vessels was diagnostically sufficient. In 13 cases no opacification of the right coronary artery was observed due to a stratification artefact. By using the PMCTA protocol with PEG200 as a carrier, a good overall image quality can be achieved. This protocol offers the possibility to standardize PMCTA with PEG200.
Keywords
Humans, Polyethylene Glycols, Contrast Media, Computed Tomography Angiography, Male, Female, Middle Aged, Aged, Autopsy/methods, Aged, 80 and over, Adult, Postmortem Imaging, PEG, PMCTA, Polyethylenglycol, Postmortem CT Angiography, Protocol
Pubmed
Web of science
Open Access
Yes
Create date
05/04/2024 9:55
Last modification date
15/06/2024 7:17
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