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Wan L, Chen J, Zhou Z, Li Z, Wang Y, Zou D, Liu N, Song F, Huang P, Zhang Z, Wang M, Xia W. The value of PMCTA in the diagnosis of coronary atherosclerosis in isolated human hearts. Forensic Sci Res 2023; 8:308-312. [PMID: 38405630 PMCID: PMC10894061 DOI: 10.1093/fsr/owad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/17/2023] [Indexed: 02/27/2024] Open
Abstract
Postmortem computed tomography (PMCT) has a limited value in investigating coronary artery disease, despite several obvious advantages over the conventional autopsy. To address this issue, postmortem computed tomography angiography (PMCTA) has been introduced into various studies, where it has been used to investigate natural and unnatural deaths involving vascular damage, occlusion, or other pathologies of the vascular system. To investigate the application value of PMCTA in the diagnosis of coronary artery stenosis in ex situ hearts, the water-based contrast media were injected into isolated hearts, scaned, and finally compared with gold standards (autopsy and histology findings of the coronary artery). This study involved 16 subjects from the Academy of Forensic Science who were suspected to have died of sudden death without traumatic injuries. Unenhanced PMCT was performed first, followed by PMCTA using a water-based contrast agent, injected into the coronary arteries of isolated hearts using a self-designed angiography device. The image data were reconstructed into three-dimensional (3D) angiography images using software in the angiography facility. The 3D images were recorded and evaluated by two radiologists and then statistically analysed. The results of PMCTA were consistent with the gold standards for the diagnosis of coronary artery stenosis (P > 0.05). However, water-based contrast media can only be used to examine the pathological changes of blood vessels, which may have limitations in the diagnosis of causes of death such as myocardial oedema. PMCTA can be used as a new method to evaluate the degree of coronary atherosclerosis in addition to traditional autopsy. The 3D reconstruction technique reveals the coronary artery lesions more objectively and vividly and provides the opportunity to re-read the data at any time. Key points The methods and parameters for coronary angiography in isolated human hearts were standardized based on the previous researcher.PMCTA in isolated human hearts is including the 3D reconstruction technique that reveals the coronary artery lesions more objectively and vividly, and provides the opportunity to re-read the data at anytime.PMCTA could only be used to examine the pathological changes of blood vessels, which might have limitations for the diagnosis of causes of death.PMCTA in isolated human hearts can be viewed as an auxiliary method for establishing the cause of death, which can provide an assessment of degree and extent of arterial stenosis and accurately help determine the abnormal location.
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Affiliation(s)
- Lei Wan
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jiemin Chen
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhilu Zhou
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
- Department of Forensic Medicine, Guizhou Medical University, Guiyang, China
| | - Zhengdong Li
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
| | - Yahui Wang
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
| | - Donghua Zou
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
| | - Ningguo Liu
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
| | - Fengxiang Song
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Ping Huang
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
| | - Zhiyong Zhang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Maowen Wang
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
| | - Wentao Xia
- Department of Forensic Pathology, Academy of Forensic Science, Shanghai, China
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A review on the evolution and characteristics of post-mortem imaging techniques. FORENSIC IMAGING 2020. [DOI: 10.1016/j.fri.2020.200420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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The Use of Transarterial Approaches in Peripheral Arteriovenous Malformations (AVMs). J Clin Med 2018; 7:jcm7050109. [PMID: 29747435 PMCID: PMC5977148 DOI: 10.3390/jcm7050109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 05/01/2018] [Accepted: 05/07/2018] [Indexed: 12/17/2022] Open
Abstract
Arteriovenous malformations (AVMs) are a subset of congenital vascular malformations (CVMs). They comprise abnormal connections between arterial and venous circulation; treatment approaches are dependent on the angioarchitecture of the AVM, specifically the number and arrangement of the feeder arteries and outflow veins. Various imaging modalities can be used to diagnose and plan treatment. Here we will review the use of transarterial approaches to treat AVMs.
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Shao Y, Wan L, Zhang J, Li Z, Liu N, Huang P, Zou D, Chen Y. Post-mortem computed tomography angiography using left ventricle cardiac puncture: A whole-body, angiographic approach. PLoS One 2017; 12:e0183408. [PMID: 28827844 PMCID: PMC5565169 DOI: 10.1371/journal.pone.0183408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 08/03/2017] [Indexed: 11/18/2022] Open
Abstract
Post-mortem computed tomography (PMCT) and PMCT angiography (PMCTA) are rapidly becoming effective and practical methods in forensic medicine. In this article, the authors introduce a whole-body PMCTA approach involving left ventricle cardiac puncture. This procedure was performed in 9 males and 3 females. PMCT was performed first. Then a biopsy core needle was used for a percutaneous puncture into the left ventricle through the intercostal area under CT guidance. 1000 mL of contrast media (diatrizoate meglumine and normal saline [0.9%] at 1:2 ratio) was injected at a rate of 50 mL/8 s, followed by CT scan. Visualization of systemic arteries was achieved in 11 cases, while only partial visualization was achieved in 1 case, which may have been related to incomplete thawing of the cadaver. PMCTA results revealed no vascular diseases and abnormalities in 10 victims. Among the 10 victims, 4 post-scan autopsies were performed and found no vascular abnormalities, consistent with the PMCTA results. Autopsy of the other 6 victims were refused by the relatives. PMCTA revealed signs of internal carotid artery aneurysm inside the sphenoid sinus in one victim, which was confirmed by autopsy. PMCTA results of another victim showed signs of stenosis and blockage of the distal part of the right vertebral artery and basilar artery. Thromboembolism of those arteries was found during autopsy. Compared with other existing PMCTA methods for examination of vascular injuries and diseases, this technique involves simple procedures, is less time consuming, has lower associated costs, does not require specialized equipment, provides adequate imaging quality, and is suitable for centres not equipped with cardiopulmonary bypass machines or other specialized equipment.
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Affiliation(s)
- Yu Shao
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
| | - Lei Wan
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
| | - Jianhua Zhang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
| | - Zhengdong Li
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
| | - Ningguo Liu
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
| | - Ping Huang
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
| | - Donghua Zou
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
- * E-mail: (DZ); (YC)
| | - Yijiu Chen
- Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Institute of Forensic Science, Ministry of Justice, P.R. China, Shanghai, China
- * E-mail: (DZ); (YC)
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Chen Y. State of the art in post-mortem forensic imaging in China. Forensic Sci Res 2017; 2:75-84. [PMID: 30483623 PMCID: PMC6197115 DOI: 10.1080/20961790.2017.1337501] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 05/30/2017] [Indexed: 10/26/2022] Open
Abstract
The autopsy and histopathologic examination are traditional and classic approaches in forensic pathology. In recent years, with the tremendous progresses of computer technology and medical imaging technology, the developed post-mortem computer tomography, post-mortem magnetic resonance imaging and other new methods provide non-invasive, intuitive, high-precision examining methods and research tools for the forensic pathology. As a result, the reconstruction of the injury as well as the analysis of injury mechanism has been essentially achieved. Such methods have become popular in the research field of forensic science and related work has also been carried out in China. This paper reviews the development and application of abovementioned post-mortem forensic imaging methods in China based on the relevant literature.
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Affiliation(s)
- Yijiu Chen
- Institute of Forensic Science, Ministry of Justice, PRC, Shanghai, China
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