Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy.
Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy.
Radiol Med. 2018 May;123(5):351-358. doi: 10.1007/s11547-018-0855-x. Epub 2018 Jan 22.
Since the 1970s, remarkable efforts have been made in the post-mortem coronary study, especially by angiography, as an added tool to diagnose heart-related deaths. In more recent times, post-mortem CT (PMCT) and post-mortem CT-angiography (PMCTA) have become an established practice in numerous forensic units, because of the undeniable advantages these diagnostic instruments can offer: data acquisition times are increasingly fast, costs have become lower and, once acquired, data can be re-utilized and re-evaluated at any given time. This review aims to chart the history of post-mortem cardiac imaging, highlighting its evolution both in terms of methodology and technology as well as the contribution that forensic radiology has been able to offer to forensic pathology, not as an alternative to autopsy but as a guide and aid when performing one. Finally, the latest advances in the study of cardiac deaths are explored, namely by cardiac post-mortem MRI (PMMR), able to visualize all the various stages of a myocardial infarction, post-mortem MRI-angiography (PMMRA), useful in investigating coronary artery pathology and post-mortem cardiac micro-CT, able to provide near-histological levels of myocardial, coronary and valvular detail.
自 20 世纪 70 年代以来，人们在死后冠状动脉研究方面做出了巨大努力，特别是通过血管造影术，作为诊断与心脏相关的死亡的附加工具。在最近的时期，死后 CT（PMCT）和死后 CT 血管造影术（PMCTA）已经在许多法医单位成为一种既定的实践，因为这些诊断仪器具有不可否认的优势：数据采集时间越来越快，成本降低，并且一旦采集，数据可以随时重新利用和重新评估。本综述旨在绘制死后心脏成像的历史，突出其在方法和技术方面的演变，以及法医放射学能够为法医病理学提供的贡献，不是作为尸检的替代方法，而是作为尸检时的指导和辅助手段。最后，探讨了心脏死亡研究的最新进展，即通过心脏死后 MRI（PMMR），能够可视化心肌梗死的所有各个阶段，死后 MRI 血管造影术（PMMRA），用于研究冠状动脉病理学，以及死后心脏微 CT，能够提供近乎组织学水平的心肌、冠状动脉和瓣膜细节。
