Evaluation of an acetated Ringer-based contrast material mixture for postmortem computed tomography angiography.
Diagn Interv Imaging
; 101(7-8): 489-497, 2020.
Article
in En
| MEDLINE
| ID: mdl-32007470
ABSTRACT
PURPOSE:
The purpose of this study was to compare an established postmortem contrast medium mixture based on polyethylene glycol (PEG) to an isotonic crystalloid with acetated Ringer solution (AR) as the base, both mixed with water-soluble iodinated contrast medium for postmortem computed tomography angiography (PMCTA) with the aim to avoid alterations of the corpse during autopsy. MATERIALS ANDMETHODS:
The study included 20 cadavers; 10 had PMCTA with AR and 10 with PEG. PMCTA images were analyzed with respect to image quality, vascular contrast patterns and artifacts. Autopsy was evaluated for visual, organ, vessel and haptic alterations. The Wilcoxon rank sum test was used to search for differences in image quality between the two groups. Statistical significance was set at P<0.05.RESULTS:
AR provided excellent contrast within the right coronary artery (P<0.001) but a lack of contrast within the left coronary artery (P=0.008) whereas PEG showed the opposite. A better image quality was observed in the PEG group by comparison with the AR group for right common carotid artery (P=0.03), left common carotid artery (P=0.01) and left coronary artery (P=0.008). No differences were found for ascending aorta (P=0.65), aortic arch (P=0.09), right circle of Willis (P=0.17), left circle of Willis (P=0.08), inferior vena cava (P=0.07) and abdominal aorta (P=0.08). Severe extravasation occurred in all (10/10; 100%) cadavers in the AR group but in none (0/10; 0%) in the PEG group (P<0.001). At autopsy, visual alteration with lilac discoloration of the face was observed in 4/10 cadavers (40%) in the AR group and in 9/10 cadavers (90%) in the PEG group (P=0.057). Haptic alterations were observed in 3/10 cadavers (30%) in the AR group and 10/10 cadavers (100%) in the PEG group (P=0.003).CONCLUSION:
AR results in contrast medium mixture extravasation in all cadavers, but PEG altered the autopsy more severely. Both carrier substances result in specific substance-related artifacts and dependent opacification of the coronary arteries, but PEG is recommended for PMCTA exclusively with regard to diagnostic imaging.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Contrast Media
/
Computed Tomography Angiography
Limits:
Humans
Language:
En
Journal:
Diagn Interv Imaging
Year:
2020
Document type:
Article
Affiliation country:
Switzerland