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Detection of hemorrhage source: the diagnostic value of post-mortem CT-angiography

C Palmiere1, S Binaghi, F Doenz

  • 1University Center of Legal Medicine Lausanne-Geneva, University of Lausanne, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland. cristian.palmiere@chuv.ch

Forensic Science International
|May 25, 2012
PubMed

Insights

Post-mortem computed tomography angiography (PMCTA) offers superior sensitivity in detecting bleeding sources compared to conventional autopsy and ante-mortem imaging. This advanced technique precisely identifies vascular lesions, aiding in determining fatal hemorrhage origins.

Area of Science:

  • Radiology
  • Forensic Pathology
  • Medical Imaging

Background:

  • Acute hemorrhage with fatal outcomes presents diagnostic challenges.
  • Conventional imaging (CT, CTA, DSA) and autopsy have limitations in identifying bleeding sources.

Purpose of the Study:

  • To compare the diagnostic accuracy of post-mortem computed tomography angiography (PMCTA) with ante-mortem imaging and conventional autopsy.
  • To evaluate PMCTA's effectiveness in detecting and localizing bleeding sources in fatal acute hemorrhages.

Main Methods:

  • Review of medical records and imaging from nine fatal hemorrhage cases.
  • Performance of multi-phase PMCTA and medico-legal autopsies.
  • Comparative analysis of localization accuracy between PMCTA, ante-mortem imaging, and autopsy.

Main Results:

  • PMCTA demonstrated higher sensitivity in detecting hemorrhage sources than ante-mortem radiological investigations.
  • PMCTA identified bleeding sources in 8 out of 9 cases, significantly outperforming conventional autopsy (3 out of 9 cases).
  • Ante-mortem and post-mortem radiological data showed similar findings, with PMCTA offering enhanced sensitivity.

Conclusions:

  • PMCTA is a highly sensitive tool for identifying the source of fatal acute hemorrhages.
  • PMCTA accurately detects arterial and/or venous lesions, comparable to clinical radiological investigations.
  • PMCTA significantly improves the localization of bleeding sources compared to conventional autopsy.

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