To see or not to see -- ambiguous findings on post-mortem cross-sectional imaging in a case of ruptured abdominal aortic aneurysm

Abstract

We present a case of a ruptured abdominal aortic aneurysm (AAA) with ambiguous accessory findings on post-mortem computed-tomography (PMCT), post-mortem magnetic resonance (PMMR) imaging, and PMCT-angiography (PMCTA) suggestive of thoracic aortic dissection. The diagnosis of ruptured AAA was confirmed by autopsy; however, there was no aortic dissection. The imaging findings that mimicked the presence of aortic dissection might have been an atypical presentation of post-mortem clotting or sedimentation. This case is an ideal example to illustrate benefits, limitations, and challenges of post-mortem cross-sectional imaging. It serves as a reminder that both, training as well as correlation of imaging findings with autopsy are fundamental to improve our understanding of radiologic findings on post-mortem cross-sectional imaging.

Keywords: Aortic dissection; Forensic radiology; Post-mortem CT; Post-mortem CT-angiography; Post-mortem MR; Ruptured aortic aneurysm; Virtopsy.