Left ventricular puncture proposed for whole-body PMCTA

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 - MR angiography, cardiac MR
MR angiography of upper extremity vascular disease.
Source: Radiographics

A team of researchers has introduced a whole-body, post-mortem CT angiography (PMCTA) approach that could save time and money without requiring specialized equipment.

By puncturing the left ventricle percutaneously and adding a contrast agent, researchers were able to identify threats for thromboembolism and aneurysm in a small sampling of cadavers.

“Complete observation of the trunk and branches of the blood vessels could be achieved,” lead researcher Yu Shao, of the Institute of Forensic Science in Shanghai, and colleagues wrote in PLOS One. “Images were with a level of quality satisfying the diagnostic demands for vascular injury and diseases.”

After executing a standard post-mortem CT (PMCT) on 12 bodies—nine males and three females—doctors used a biopsy needle to puncture the left ventricle under CT guidance. They then injected one liter of contrast media and performed a CT scan.

Visualization of systemic arteries was achieved in 11 cases, while only partial visualization occurred in the other victim—likely a result of an incomplete thawing of the cadaver, according to Shao and colleagues. A single PMCT and PMCTA procedure took about 30 minutes.

Autopsies of six of the victims confirmed corresponding results to those suggested by PMCT and PMCTA. Four PMCTAs showed no vascular abnormalities, one showed signs of an internal carotid artery aneurysm confirmed by autopsy and one demonstrated signs of stenosis and blockage of multiple arteries before autopsy revealed the occurrence of a thromboembolism. Researchers didn’t receive permission to perform autopsies on the other six victims.

“This study introduced a novel whole-body PMCTA approach, which is simple, less time-consuming, provides adequate image quality, with accuracy of diagnosis and low demands for specialized equipment and funding,” Shao et al. wrote.

The authors pointed out this method is only able to show the systemic arterial circulatory system and not the coronary arteries, pulmonary arteries or veins. Also, the decomposition and thawing of cadavers can impact the results of angiography, as demonstrated by the case where only partial visualization was achieved.