Pitfalls in post-mortem CT-angiography--intravascular contrast induces post-mortem pericardial effusion

Berger, Nicole; Martinez, Rosita; Winklhofer, Sebastian; Flach, Patricia M.; Ross, Steffen; Ampanozi, Garyfalia; Gascho, Dominic; Thali, Michael J.; Ruder, Thomas (2013). Pitfalls in post-mortem CT-angiography--intravascular contrast induces post-mortem pericardial effusion. Legal medicine, 15(6), pp. 315-317. Elsevier 10.1016/j.legalmed.2013.07.001

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We present a case where multi-phase post-mortem computed tomography angiography (PMCTA) induced a hemorrhagic pericardial effusion during the venous phase of angiography. Post-mortem non-contrast CT (PMCT) suggested the presence of a ruptured aortic dissection. This diagnosis was confirmed by PMCTA after pressure controlled arterial injection of contrast. During the second phase of multi-phase PMCTA the presence of contrast leakage from the inferior cava vein into the pericardial sac was noted. Autopsy confirmed the post-mortem nature of this vascular tear. This case teaches us an important lesson: it underlines the necessity to critically analyze PMCT and PMCTA images in order to distinguish between artifacts, true pathologies and iatrogenic findings. In cases with ambiguous findings such as the case reported here, correlation of imaging findings with autopsy is elementary.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Ruder, Thomas


600 Technology > 610 Medicine & health








Aisha Stefania Mzinga

Date Deposited:

13 May 2014 10:00

Last Modified:

13 May 2014 10:00

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Artifact, Forensic radiology, Post-mortem computed tomography angiography, Vascular injury, Virtopsy



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