Troxler Renaud, Minoiu Costin, Vaucher Paul, Michaud Katarzyna, Doenz Francesco, Ducrot Kewin, Grabherr Silke
University Center of Legal Medicine Lausanne-Geneva, Chemin de la Vulliette 4, 1000, 25, Lausanne, Switzerland.
University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
Int J Legal Med. 2018 Jan;132(1):249-262. doi: 10.1007/s00414-017-1652-0. Epub 2017 Jul 24.
Postmortem CT angiography is the method of choice for the postmortem imaging investigations of the cardiovascular (CV) system. However, autopsy still remains the gold standard for CV measurement. Nevertheless, there are not any studies on CV measurements on the multi-phase postmortem angiography (MPMCTA) which includes comparisons with autopsy. Therefore, the aim of this study is to compare CV measurements between the native CT scan and the three phases of the MPMCTA to find out which of these modalities correlate the best with autopsy measurements.
For this study, we selected retrospectively 50 postmortem cases that underwent both MPMCTA and autopsy. A comparison was carried out between the CV measurements obtained with imaging (aorta; heart cavities and cardiac wall thicknesses; maximum cardiac diameter and cardiothoracic ratio) and at the autopsy (aorta; cardiac valves, ventricular thicknesses, and weight).
Our results show that the dynamic phase displays an advantage for the measurement of the aortas. However, the MPMCTA is not accurate to measure the cardiac wall thicknesses. The measurements of the heart cavities show no correlation with the heart valves. The cardiothoracic ratio measured by the MPMCTA shows no correlation with the heart weight. Nevertheless, the maximum cardiac diameter exhibits a correlation with the latter on the venous and dynamic phase.
These results show that only few CV parameters measured with imaging correlate with measurement obtained at the autopsy. These results indicate that in order to better estimate values obtained at the autopsy, we need to define new reference values for the CV measurement on MPMCTA.
尸检CT血管造影是心血管(CV)系统尸检成像研究的首选方法。然而,尸检仍是CV测量的金标准。尽管如此,目前尚无关于多期尸检血管造影(MPMCTA)中CV测量的研究,包括与尸检的比较。因此,本研究的目的是比较原始CT扫描与MPMCTA三个阶段的CV测量结果,以找出哪种方式与尸检测量结果相关性最佳。
在本研究中,我们回顾性选择了50例同时接受MPMCTA和尸检的病例。对成像(主动脉;心腔和心肌壁厚度;最大心脏直径和心胸比率)和尸检(主动脉;心脏瓣膜、心室厚度和重量)获得的CV测量结果进行了比较。
我们的结果表明,动态期在主动脉测量方面具有优势。然而,MPMCTA在测量心肌壁厚度方面不准确。心腔测量结果与心脏瓣膜无相关性。MPMCTA测量的心胸比率与心脏重量无相关性。尽管如此,最大心脏直径在静脉期和动态期与后者具有相关性。
这些结果表明,成像测量的CV参数中只有少数与尸检获得的测量结果相关。这些结果表明,为了更好地估计尸检获得的值,我们需要为MPMCTA上的CV测量定义新的参考值。