Visualization of Myocardial Infarction in Postmortem... : The American Journal of Forensic Medicine and Pathology (original) (raw)

Original Article

Visualization of Myocardial Infarction in Postmortem Multiphase Computed Tomography Angiography

A Feasibility Study

Sabatasso, Sara MD*; Vanhaebost, Jessica MD†; Doenz, Francesco MD‡; Palmiere, Cristian MD*; Michaud, Katarzyna MD*; Dedouit, Fabrice MD*; Grabherr, Silke MD*

From the *University Center of Legal Medicine Lausanne-Geneva, Geneva, Switzerland; †Cliniques Universitaires Saint-Luc, Service de Médecine Légale, Brussels, Belgium; and ‡Centre Hospitalier Universitaire Vaudois (CHUV), Service de Radiologie, Lausanne, Switzerland.

Manuscript received July 13, 2017; accepted October 29, 2017.

The authors report no conflict of interest.

Reprints: Sara Sabatasso, MD, University Center of Legal Medicine Lausanne-Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland. E-mail: [email protected].

The American Journal of Forensic Medicine and Pathology 39(2):p 106-113, June 2018. | DOI: 10.1097/PAF.0000000000000372

Abstract

Recent studies have indicated that multiphase postmortem computed tomography angiography (MPMCTA) allows detection of a pathological enhancement of the myocardium in regions that correlate with the localization of the infarction at histology. The aim of this study was to verify this hypothesis by examining MPMCTA images in cases of myocardial infarction. Therefore, we investigated 10 autopsy cases where death was attributed to myocardial infarction or which showed cardiovascular pathology. As a control group, we selected 10 cases of non-natural (namely, not cardiac) death. The MPMCTA was performed in both groups to ascertain whether a pathological enhancement could be observed. We detected a myocardial enhancement in all cardiac death cases, in the same region that showed infarction at histology. No enhancement was observed in control cases. These results have important implications in the routine management of sudden cardiac death cases. In fact, MPMCTA can not only orient about the cause of death before autopsy, but can especially help to identify affected regions for guiding and improving the sampling for microscopic examination.