Detection of coronary thrombosis after multi-phase postmortem CT-angiography

Area of Science:

• Forensic Pathology
• Radiology
• Cardiovascular Pathology

Background:

• Accurate diagnosis of acute coronary thrombosis is crucial in medicolegal cases.
• Established diagnostic methods for postmortem coronary thrombosis can be limited.

Purpose of the Study:

• To compare the diagnostic accuracy of postmortem angiography, autopsy, and histology for acute coronary thrombosis.
• To evaluate the utility of multiphase CT-angiography in identifying coronary arterial thrombi.

Main Methods:

• A series of 150 medicolegal cases underwent native CT-scan, postmortem angiography, conventional autopsy, and histological examination.
• Coronary arteries were specifically examined for luminal filling defects and collateral vessels.

Main Results:

• Postmortem angiography revealed coronary arterial luminal filling defects suggestive of acute thrombosis in 10 cases, confirmed by autopsy and histology.
• In 40 cases, filling defects were observed with collateral vessels, but histology did not confirm acute thrombi.
• Postmortem angiography demonstrated findings consistent with acute coronary thrombosis in 10% of cases.

Conclusions:

• Postmortem angiography, while not fully established, can detect coronary arterial luminal filling defects indicative of acute thrombosis.
• Findings from postmortem angiography require confirmation through autopsy and histological examinations for definitive diagnosis.
• Multiphase CT-angiography shows promise in identifying acute coronary thrombosis in forensic investigations.