Hyperattenuating aortic wall on postmortem computed tomography (PMCT).

PURPOSE

To quantitatively evaluate the finding of hyperattenuating aortic wall on postmortem computed tomography (PMCT) and investigate its causes.

MATERIALS AND METHODS

Our subjects were 50 PMCT of non-traumatic deaths and 50 CT of living persons (live CT). The ascending aorta at the level of the carina was visually assessed regarding the presence or absence of hyperattanuating aortic wall and hematocrit effect on PMCT and live CT. The diameter, thickness of the aortic wall, and CT number (HU) of the aortic wall and the lumen were also measured.

RESULTS

Hyperattenuating aortic wall was detected in 100% of PMCT and 2% of live CT. The diameter of the aortic wall was 2.9 +/- 0.5 cm on PMCT and 3.5 +/- 0.5 cm on live CT, showing a significant difference. The thickness of the aortic wall was 2 mm on PMCT. Hematocrit effect was observed in 46% of PMCT and in none of live CT. With PMCT, there was a significant difference between the CT numbers of the upper and lower half portions of the lumen (19.6 +/- 11.7/30.9 +/- 12.9), whereas, with live CT, there was no such significant difference (37.4 +/- 7.6/38.9 +/- 6.7), with the overall value of 38.2 +/- 6.7. The CT number of the aortic wall was 49.9 +/- 10.9 on PMCT.

CONCLUSION

The causes of hyperattenuating aortic wall on PMCT are considered to be increased attenuation due to contraction of the aortic wall, a lack of motion artifact, and decreased attenuation of the lumen due to dilution of blood after massive infusion at the time of cardiopulmonary resuscitation.