Okuma Hidemi, Gonoi Wataru, Ishida Masanori, Shintani Yukako, Takazawa Yutaka, Fukayama Masashi, Ohtomo Kuni
Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
Int J Legal Med. 2014 Nov;128(6):987-93. doi: 10.1007/s00414-013-0955-z. Epub 2013 Dec 19.
To evaluate postmortem changes of the aorta on postmortem computed tomography (CT) in comparison with those on antemortem CT obtained in the same patients.
We studied 57 consecutive patients who had undergone antemortem CT, postmortem CT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. Postmortem CT was performed within 20 h after death, followed by pathological autopsy. Pathological autopsy confirmed the absence of cardiovascular disease such as aortic aneurysm, aortic dissection, or Marfan syndrome in all patients. Aortic wall thickness and aortic cross-sectional areas were measured on both antemortem CT and postmortem CT. Difference in aortic wall thickness between antemortem CT with and without contrast medium, and between antemortem CT and postmortem CT, and in cross-sectional area of the aortic wall between antemortem CT and postmortem CT was evaluated statistically.
No significant difference in aortic wall thickness was observed on antemortem CT in comparison of contrasted and non-contrasted images. The aortic wall was significantly thicker on postmortem CT than on antemortem CT (p < 0.0001). No significant difference in cross-sectional area of the aortic wall was observed between antemortem CT and postmortem CT measurements.
This is the first longitudinal study to confirm greater thickness of the aortic wall on postmortem images compared with antemortem images in the same patients and to show no change in cross-sectional area of the aortic wall between before and after death.
通过与同一患者生前CT检查结果对比,评估尸体计算机断层扫描(CT)中主动脉的死后变化。
我们研究了2009年4月至2010年12月期间在我们三级医疗中心连续接受生前CT、死后CT及病理尸检的57例患者。死后CT在死亡后20小时内进行,随后进行病理尸检。病理尸检证实所有患者均无心血管疾病,如主动脉瘤、主动脉夹层或马凡综合征。在生前CT和死后CT上均测量主动脉壁厚度和主动脉横截面积。对生前CT使用对比剂和未使用对比剂时的主动脉壁厚度差异、生前CT与死后CT之间的主动脉壁厚度差异以及生前CT与死后CT之间的主动脉壁横截面积差异进行统计学评估。
在生前CT上,对比剂增强图像与未增强图像的主动脉壁厚度无显著差异。死后CT上的主动脉壁明显比生前CT厚(p < 0.0001)。生前CT与死后CT测量的主动脉壁横截面积无显著差异。
这是第一项纵向研究,证实同一患者死后图像上的主动脉壁厚度比生前图像更厚,且显示死亡前后主动脉壁横截面积无变化。