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Multi-phase postmortem CT angiography: recognizing technique-related artefacts and pitfalls
C Bruguier1, P J Mosimann, P Vaucher
1University Centre of Legal Medicine, Lausanne-Geneva, University Hospital of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland. christine.bruguier@chuv.ch
Background And Purpose:
Multi-phase postmortem CT angiography (MPMCTA) is increasingly being recognized as a valuable adjunct medicolegal tool to explore the vascular system. Adequate interpretation, however, requires knowledge about the most common technique-related artefacts. The purpose of this study was to identify and index the possible artefacts related to MPMCTA.
Material And Methods:
An experienced radiologist blinded to all clinical and forensic data retrospectively reviewed 49 MPMCTAs. Each angiographic phase, i.e. arterial, venous and dynamic, was analysed separately to identify phase-specific artefacts based on location and aspect.
Results:
Incomplete contrast filling of the cerebral venous system was the most commonly encountered artefact, followed by contrast agent layering in the lumen of the thoracic aorta. Enhancement or so-called oedematization of the digestive system mucosa was also frequently observed.
Conclusion:
All MPMCTA artefacts observed and described here are reproducible and easily identifiable. Knowledge about these artefacts is important to avoid misinterpreting them as pathological findings.
Insights
Multi-phase postmortem CT angiography (MPMCTA) is a valuable medicolegal tool. This study identifies common MPMCTA artifacts, such as incomplete venous filling, to prevent misinterpretation as pathology.
Area of Science:
- Forensic radiology
- Medical imaging techniques
Background:
- Multi-phase postmortem CT angiography (MPMCTA) is an emerging medicolegal tool.
- Accurate interpretation of MPMCTA requires understanding technique-related artifacts.
Purpose of the Study:
- To identify and catalog potential artifacts associated with MPMCTA.
- To improve the diagnostic accuracy of MPMCTA in forensic investigations.
Main Methods:
- Retrospective review of 49 MPMCTAs by an experienced radiologist.
- Separate analysis of arterial, venous, and dynamic phases to identify phase-specific artifacts.
Main Results:
- The most frequent artifact was incomplete contrast filling of the cerebral venous system.
- Contrast agent layering in the thoracic aorta and digestive system mucosal enhancement were also common.
Conclusions:
- MPMCTA artifacts are reproducible and identifiable.
- Awareness of these artifacts is crucial to avoid misdiagnosis of pathological conditions.
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