Comparative Analysis of Artery Anatomy Evaluated by Postmortem Tomography, CT Angiography, and Postmortem and Predeath CT Scans

Abstract

To date, no study has been performed analyzing changes in the vascular system comparing paired examinations of patients alive and after death with the use of cardiopulmonary bypass and computed tomography (CT) angiography. The aim of this study was to analyze in a large series (38 patients) the aorta and its branches by CT (without contrast) and CT angiography of patients still alive and after death comparing their diameters and length variations. The variation between invivo tomography and virtopsy methods was greater in the evaluation of distances between vascular segments than in the diameters; less than 30% of the distances evaluated in the entire study had acceptable variation between methods, regardless of the use of contrast scans. We observed better repeatability rates in the comparison between invivo and postmortem contrast-enhanced examinations. Comparing the examinations of the still alive individuals with the contrast-enhanced tomography after death, we observed a higher concordance rate. The best variations between the methods were observed in the evaluation of the diameters in the contrast-enhanced examination of the ascending aorta, aortic arch, thoracic aorta, and thoracoabdominal transition. The measurements obtained in postmortem angiography images partially reflect the vascular anatomy of the main branches in the thoracoabdominal region invivo. However, postmortem CT without contrast was not performed in the same comparison. We believe that adjustments to the contrast injection technique may eventually improve these results.