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Post-Mortem CT Angiography Increases Forensic Accuracy

By MedImaging International staff writers
Posted on 04 Jul 2018

Image: A new study suggests post-mortem CT angiography helps uncover causes of death (Photo courtesy of Royal Preston Hospital).

A new study suggests that post-mortem CT angiography (PMCTA) can detect 90% of incidental findings, while autopsy finds only 61%.

Researchers at the University Center of Legal Medicine Lausanne-Geneva (CURML; Switzerland), the University of Leipzig (Germany), and other institutions conducted an autopsy study on 500 human corpses to determine if computed tomography (CT) and PMCTA could help to detect more lesions than autopsy alone, to evaluate the strengths and weaknesses of each method, and to define their indications. All images were read by an experienced team including one forensic pathologist and one radiologist blinded to the autopsy results.

The results revealed that among 18,654 findings, autopsies identified 61.3%, postmortem CT helped to identify 76%, and PMCTA helped identify 89.9%. PMCTA was superior to autopsy, especially at helping to identify essential skeletal and vascular lesions. Among the forensically essential findings, 23.4% were not detected at autopsy, while only 9.7% were missed at PMCTA. The best results were obtained when PMCTA was combined with autopsy. The study was published on May 1, 2018, in Radiology.

“The idea of the PMCTA is to simulate a post-mortem circulation. The heart is ‘replaced’ by a perfusion device, similar to the heart-lung machine that replaces the heart during heart surgery,” said lead author Silke Grabherr, MD, PhD, of CURML. “This method could, in many cases, be an alternative to invasive autopsy if such an opening of the body is not possible. This offers new investigation possibilities, for example, in countries where a conventional autopsy is not accepted or in cases where family members can refuse it.”

“The combination of bone lesions and vascular lesions is especially seen in cases of traumatic death, such as falls from height, traffic accidents, ballistic trauma, and sharp trauma in homicides and suicides,” concluded Dr. Grabherr. “This means that PMCTA is an excellent choice to investigate such cases, and can be used combined with or even independently of conventional autopsy for investigating in these cases.”

Compared with conventional autopsy, postmortem CT has several advantages, but the main reported weakness is relatively low soft-tissue contrast, especially in organ parenchyma, and poor ability to view the vascular system. This limitation can be overcome by using a scanning protocol and specific perfusion devices, with an intravenous oil-based contrast agent of specific viscosity. The most widespread single approach for postmortem angiography today is multiphase PMCTA.

Related Links:
University Center of Legal Medicine Lausanne-Geneva
University of Leipzig

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69 (192.16537475586): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (254.15420532227): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 1828.9089202881): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (197.17216491699): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (259.8762512207): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (59.843063354492): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (61.03515625): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (249.14741516113): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (57.220458984375): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (75.817108154297): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3824.9492645264): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

105 (152.1110534668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

106 (144.00482177734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774032 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (96.08268737793): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774032 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

109 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

110 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294774032 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (417.94776916504): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294774032 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (624.8950958252): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (378.13186645508): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

115 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

116 (144.00482177734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

117 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

118 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

119 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

120 (319.00405883789): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 158940.79208374): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (722.88513183594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

123 (318.05038452148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

124 (!!!!! 2921.8196868896): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774032 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774032 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 657664.06059265): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (91.075897216797): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (53.882598876953): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (31.948089599609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (73.19450378418): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (51.975250244141): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (550.0316619873): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (451.08795166016): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (46.968460083008): SELECT name FROM jos_deeppockets WHERE id=215

136 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=215

137 (510.93101501465): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (447.98851013184): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

140 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

141 (!!!!! 12356.042861938): TRUNCATE TABLE jos_trademed_module

142 (108.00361633301): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774032 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (94.890594482422): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774032 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (501.87110900879): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

147 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

148 (!!!!! 1342.0581817627): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

150 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

151 (46.968460083008): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774032 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774032 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (37.908554077148): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (32.901763916016): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

156 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774032 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774032 AND published='1' LIMIT 1

157 (38.862228393555): select jos_twitters.link from jos_twitters where cat=10

158 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

159 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

160 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

161 (234.84230041504): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2408.9813232422): insert into jos_banners_delta values (14615,'2025-06-20 08:46:56','216.73.216.120','view'),(14202,'2025-06-20 08:46:56','216.73.216.120','view'),(14203,'2025-06-20 08:46:56','216.73.216.120','view')

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