Advantages of Postmortem Angiography in the Daily Routine of Legal Medicine

Abstract

If applied by an experienced team, postmortem CT angiography (PMCTA) has a number of advantages, most of which have been explained in detail in earlier sections of this book. But PMCTA also enhances daily routine procedures when determining the cause of death. To date, the gold standard for determining the cause of death has been conventional autopsy in most countries. However, numerous publications have described the impressive gains in quality that can be obtained by combining radiologic methods with conventional autopsy [1–4]. Whole-body PMCTA combined with autopsy is already considered a gold standard in cases of fatal hemorrhage and medical malpractice. The use of radiologic imaging modalities delivers an additional piece of information, such as looking at a situation from a different angle and thus enabling a more confident diagnosis of relevant pathologic changes and ultimately the cause of death. Both postmortem CT (PMCT) and PMCTA can be performed quickly and allow for a quick determination of whether additional examinations are necessary. PMCT and PMCTA can thus be used as triage tools. As such, they can help save time and resources, an aspect that increases in significance if large numbers of bodies need to be examined, e.g., in mass casualties. Furthermore, radiologic reports can be integrated into the final forensic case report by the forensic pathologist in charge of the case. For illustration purposes, radiologic images can be integrated into the forensic report, which facilitates understanding of lesions and lesion patterns for medical laypersons or judicial authorities and may replace “bloody” autopsy images and lengthy written explanations.