Fatima-Zohra Mokrane1, Frederic Savall2, Laurent Dercle3, Eric Crubezy4, Norbert Telmon2, Hervé Rousseau5, Fabrice Dedouit6. 1. Service de Radiologie, CHU Toulouse-Rangueil, 1 avenue du Professeur Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France; Laboratoire AMIS-anthropologie moléculaire et imagerie de synthèse, UMR 2855, Faculté de Médecine Purpan, 37 Allées Jules Guesde, 31073 Toulouse cedex 7, France. Electronic address: mokrane_fatimazohra@yahoo.fr. 2. Service de Médecine Légale, CHU Toulouse-Rangueil, 1 avenue du Professeur Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France; Laboratoire AMIS-anthropologie moléculaire et imagerie de synthèse, UMR 2855, Faculté de Médecine Purpan, 37 Allées Jules Guesde, 31073 Toulouse cedex 7, France. 3. Gustave Roussy Institute, Université Paris-Saclay, Villejuif F-94805, France; New York Presbyterian Hospital, Columbia University, New York, NY 10039, USA. 4. Laboratoire AMIS-anthropologie moléculaire et imagerie de synthèse, UMR 2855, Faculté de Médecine Purpan, 37 Allées Jules Guesde, 31073 Toulouse cedex 7, France. 5. Service de Radiologie, CHU Toulouse-Rangueil, 1 avenue du Professeur Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France. 6. Service de Médecine Légale, CHU Toulouse-Rangueil, 1 avenue du Professeur Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France; Unité d'imagerie et d'anthropologie forensiques, Centre universitaire romand de médecine légale, chemin de la Vulliette, Lausanne, Switzerland.
Abstract
PURPOSE: Multi-phase post-mortem computed tomography angiography (MPMCTA) is a new diagnostic tool, used in forensic pathology. On the one hand, this technique allows a better and direct visualization of vascular and solid organ lesions. On the other hand, the invasiveness of the procedure-which requires surgical denudation (inguinal and/or cervical) and the insertion of surgical cannulas-leads to many relatives refusing scientific autopsies. Our hypothesis states that a minimally-invasive procedure combining interventional radiological techniques with MPMCTA (replacement of surgical cannulas by radiological catheters) will improve the approval rate of scientific autopsies by families. The aim of this study was to evaluate the feasibility of the minimally-invasive MPMCTA approach and to compare its performance to the current reference-standard (the conventional approach). MATERIAL AND METHODS: We included consecutively 16 corpses divided in two groups according to the contrast enhancement approach: radiological catheters (n=8), and surgical cannulas (n=8). Corpses were chosen and assigned randomly from our local data. The quality of the imaging procedure was compared according to four items: global vascular opacification, cerebral venous opacification, and lower limbs opacification (arterial and venous). RESULTS: A minimally-invasive approach for scientific autopsies is feasible through a radiological catheter. Vascular opacification was optimal in 8 out of 8 cases and was no less effective than the control reference group using surgical cannula incision associated with their non-occlusive aspects.
PURPOSE: Multi-phase post-mortem computed tomography angiography (MPMCTA) is a new diagnostic tool, used in forensic pathology. On the one hand, this technique allows a better and direct visualization of vascular and solid organ lesions. On the other hand, the invasiveness of the procedure-which requires surgical denudation (inguinal and/or cervical) and the insertion of surgical cannulas-leads to many relatives refusing scientific autopsies. Our hypothesis states that a minimally-invasive procedure combining interventional radiological techniques with MPMCTA (replacement of surgical cannulas by radiological catheters) will improve the approval rate of scientific autopsies by families. The aim of this study was to evaluate the feasibility of the minimally-invasive MPMCTA approach and to compare its performance to the current reference-standard (the conventional approach). MATERIAL AND METHODS: We included consecutively 16 corpses divided in two groups according to the contrast enhancement approach: radiological catheters (n=8), and surgical cannulas (n=8). Corpses were chosen and assigned randomly from our local data. The quality of the imaging procedure was compared according to four items: global vascular opacification, cerebral venous opacification, and lower limbs opacification (arterial and venous). RESULTS: A minimally-invasive approach for scientific autopsies is feasible through a radiological catheter. Vascular opacification was optimal in 8 out of 8 cases and was no less effective than the control reference group using surgical cannula incision associated with their non-occlusive aspects.