Multi-phase postmortem CT angiography: recognizing technique-related artefacts and pitfalls

Int J Legal Med. 2013 May;127(3):639-52. doi: 10.1007/s00414-013-0840-9. Epub 2013 Mar 21.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography / methods*
  • Artifacts*
  • Autopsy / methods*
  • Cardiovascular System / diagnostic imaging
  • Cardiovascular System / pathology
  • Cause of Death
  • Digestive System / blood supply
  • Digestive System / diagnostic imaging
  • Digestive System / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Single-Blind Method
  • Tomography, X-Ray Computed / methods*