University Center of Legal Medicine Lausanne-Geneva, University Hospital of Lausanne, Chemin de la Vulliette 4, 1000, Lausanne 25, Switzerland,
Radiol Med. 2015 Sep;120(9):824-34. doi: 10.1007/s11547-015-0532-2. Epub 2015 Apr 5.
The application of contrast media in post-mortem radiology differs from clinical approaches in living patients. Post-mortem changes in the vascular system and the absence of blood flow lead to specific problems that have to be considered for the performance of post-mortem angiography. In addition, interpreting the images is challenging due to technique-related and post-mortem artefacts that have to be known and that are specific for each applied technique. Although the idea of injecting contrast media is old, classic methods are not simply transferable to modern radiological techniques in forensic medicine, as they are mostly dedicated to single-organ studies or applicable only shortly after death. With the introduction of modern imaging techniques, such as post-mortem computed tomography (PMCT) and post-mortem magnetic resonance (PMMR), to forensic death investigations, intensive research started to explore their advantages and limitations compared to conventional autopsy. PMCT has already become a routine investigation in several centres, and different techniques have been developed to better visualise the vascular system and organ parenchyma in PMCT. In contrast, the use of PMMR is still limited due to practical issues, and research is now starting in the field of PMMR angiography. This article gives an overview of the problems in post-mortem contrast media application, the various classic and modern techniques, and the issues to consider by using different media.
对比剂在法医死后放射学中的应用与在活体患者中的临床方法不同。血管系统的死后变化和血流的缺失导致了特定的问题,这些问题必须在进行死后血管造影时考虑到。此外,由于技术相关和死后伪影的存在,解释图像具有挑战性,这些伪影必须被了解,并且对于每种应用的技术都是特定的。尽管注射对比剂的想法由来已久,但经典方法并不能简单地应用于法医学中的现代放射技术,因为它们大多专门用于单个器官的研究,或者仅在死后很短的时间内适用。随着现代成像技术(如死后计算机断层扫描(PMCT)和死后磁共振成像(PMMR))在法医死亡调查中的引入,人们开始进行深入研究,以探索它们与传统尸检相比的优缺点。PMCT 已经在多个中心成为常规检查,并且已经开发出不同的技术来更好地可视化 PMCT 中的血管系统和器官实质。相比之下,由于实际问题,PMMR 的使用仍然受到限制,并且现在正在 PMMR 血管造影领域开始研究。本文概述了死后对比剂应用中的问题、各种经典和现代技术,以及使用不同介质时需要考虑的问题。