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Histomorphological assessment of isolated abdominal organs after targeted perfusion with the contrast agent Angiofil® in postmortem computed tomography angiography.

Authors
  • Stumm, Christian Jean-Paul1
  • Wittig, Holger2
  • Kalberer, Nicole M3
  • Scheurer, Eva4
  • 1 Institute of Forensic Medicine, University Basel, Health Department Basel-Stadt, Pestalozzistrasse 22, 4056 Basel, Switzerland. Electronic address: [email protected] , (Switzerland)
  • 2 Institute of Forensic Medicine, University Basel, Health Department Basel-Stadt, Pestalozzistrasse 22, 4056 Basel, Switzerland. Electronic address: [email protected] , (Switzerland)
  • 3 Institute of Forensic Medicine, University Basel, Health Department Basel-Stadt, Pestalozzistrasse 22, 4056 Basel, Switzerland. Electronic address: [email protected] , (Switzerland)
  • 4 Institute of Forensic Medicine, University Basel, Health Department Basel-Stadt, Pestalozzistrasse 22, 4056 Basel, Switzerland. Electronic address: [email protected] , (Switzerland)
Type
Published Article
Journal
Forensic science international
Publication Date
Oct 01, 2020
Volume
315
Pages
110427–110427
Identifiers
DOI: 10.1016/j.forsciint.2020.110427
PMID: 32771885
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The current literature about histological alterations and artefacts associated with postmortem computed tomography angiography (PMCTA) is scarce and limited to qualitative research. The aim of this study was to describe and quantify histological alterations and artefacts in histologic specimens of the inner organs. The spleen, the liver, the kidneys and the pancreas were eviscerated in the course of standard forensic autopsy, followed by manual arterial and venous perfusion of the organs with the lipophilic contrast agent Angiofil®. Computed tomography (CT) of the organ packages was executed to evaluate if the perfusion with Angiofil® was sufficient. The CT scans revealed a good delineation of the vessel trees up to the organ periphery, suggesting a sufficient perfusion. Tissue samples were taken before and after perfusion, stained with hematoxylin-eosin (H&E) and examined by using microscopy. Native and perfused specimens were assessed on the basis of a qualitative rating scale in regard to the integrity of the cells, the tissue architecture and induced alterations. Subsequently the observed differences before and after perfusion with Angiofil® were analyzed quantitatively. While the liver, spleen and kidneys could be evaluated, further microscopic examinations of the pancreatic tissue were not possible due to vast autolytic changes. On the cellular level no changes in the liver, spleen and kidneys were observed after administering Angiofil®. While the tissue architecture of these organs remained intact, a significant blood volume displacement occurred. As a consequence, tissue with hypoemic or normal blood state demonstrated congestion. Further, optically empty spaces emerged regularly in the vessels and the parenchyma of each organ as a surrogate for the lipophilic contrast agent. With a few exceptions an adequate perfusion up to the microscopic level was observed. Following the results of this investigation, CT-controlled manual injection of Angiofil® into isolated organs may be an alternative to the generalized in situ application of contrast agents in the course of PMCTA. It is of eminent importance to know the artefacts induced by an Angiofil® injection in order to avoid a misinterpretation or a masking of findings. Thus, a collection of native tissue specimens has to be done before contrast agent application. Copyright © 2020 Elsevier B.V. All rights reserved.

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