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Related Experiment Video

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Evaluation of an acetated Ringer-based contrast material mixture for postmortem computed tomography angiography.

A R J Péporté1, D Gascho2, S Stamou3

  • 1Clinic for Radiology and Nuclear Medicine, Cantonal Hospital Saint-Gallen, 9007 Saint-Gallen, Switzerland.

Diagnostic and Interventional Imaging
|February 3, 2020
PubMed
Summary

Polyethylene glycol (PEG) contrast medium shows superior image quality for postmortem computed tomography angiography (PMCTA) compared to acetated Ringer solution (AR). While AR causes extravasation, PEG leads to more severe autopsy alterations, but is recommended for diagnostic imaging.

Keywords:
AutopsyContrast media mixturePostmortem computed tomography (PMCT)Postmortem computed tomography angiography (PMCTA)Virtopsy

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Area of Science:

  • Forensic Radiology
  • Medical Imaging
  • Toxicology

Background:

  • Postmortem computed tomography angiography (PMCTA) is a valuable tool in forensic investigations.
  • Contrast media are essential for visualizing vascular structures in PMCTA.
  • Minimizing postmortem alterations is crucial for accurate autopsy findings.

Purpose of the Study:

  • To compare the efficacy and safety of polyethylene glycol (PEG) based contrast medium versus acetated Ringer solution (AR) for PMCTA.
  • To evaluate image quality, vascular opacification, and postmortem alterations associated with each contrast medium.

Main Methods:

  • Twenty cadavers underwent PMCTA, with 10 receiving AR and 10 receiving PEG contrast medium.
  • Image quality, vascular contrast, and artifacts were assessed.
  • Autopsy findings, including visual, organ, vessel, and haptic alterations, were documented.

Main Results:

  • PEG demonstrated better image quality in the carotid arteries and left coronary artery compared to AR.
  • Acetated Ringer solution (AR) resulted in severe contrast medium extravasation in all cases.
  • Polyethylene glycol (PEG) caused more significant visual and haptic alterations during autopsy.

Conclusions:

  • Acetated Ringer solution (AR) leads to universal contrast extravasation, compromising PMCTA integrity.
  • Polyethylene glycol (PEG) offers superior diagnostic imaging quality for PMCTA but causes more severe postmortem alterations.
  • PEG is recommended for PMCTA when diagnostic imaging is the primary objective, despite autopsy alterations.