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

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.