Combination of post mortem coronary angiography, corrosion cast method and multi-slice computed tomography (MSCT) for diagnostic improvement in pathology and forensics

Abstract

Abstract In recent years, post mortem multi-slice computed tomography (MSCT) is increasingly applied for forensic and pathologic examination. However, classical dissection remains dominant in everyday practice. Lack of quantifiable data on the coronary system has become a disadvantageous attribute of traditional autopsy. Therefore, post mortem MSCT angiography was performed in 80 ex corpo hearts with the aim of improving the accuracy and quantitative documentation of pathologic and forensic diagnoses of coronary artery disease (CAD). Hearts were perfused by introducing a new oily or synthetic resin, or using both contrast materials successively. Then the perfused organs were processed for imaging. Detailed angiographic analysis enabled us to localize, map and quantify coronary calcifications, stenoses, and to characterize the types of atherosclerotic plaques. Significant early or late complications of widely used percutaneous coronary interventions (PCI) and coronary bypass surgery (CABS) could be revealed using CT analysis. Furthermore, by using our oily contrast material and CT imaging, we could identify and visualize the clinically important small caliber nodal arteries (diameter 0.4–2.0 mm). The present work suggests that post mortem CT angiography and post-processing of the data may improve the quality of pathologic and forensic diagnosis. Our collection of coronary casts including digital data are available for further analysis.