Pierre-Eloi Laurent

Post-mortem computed tomography in a case of suicide by air embolism

a Laboratoire d’imagerie interventionnelle expérimentale, faculté de médecine, Aix-Marseille université, boulevard Jean-Moulin, 13385 Marseille cedex 5, France b Pôle imagerie médicale, service de radiologie, hôpital de la Timone, Assistance publique des Hôpitaux de Marseille, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France c Pôle RUSH, service de médecine hyperbare, hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13274 Marseille cedex 9, France d UMR MD2, dysoxie tissulaire, Aix-Marseille université, boulevard Pierre-Dramard, 13916 Marseille cedex 20, France e Service de médecine légale et droit à la santé, hôpital de la Timone, Assistance publique des Hôpitaux de Marseille, 264, rue Saint-Pierre, Marseille cedex 05, France

The future of pediatric and perinatal postmortem imaging

The field and applications of postmortem imaging are exponentially growing. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented, as well as its use in drug mule identification. In pediatric and perinatal practice, large significant series are less available, except for MRI and central nervous system analysis where scientific evidence is now robust. In this review, after a short historical review and analysis of current problems and challenges, we will try to depict the way we see the future of this subspecialty of postmortem cross-sectional imaging, including all specific situations: terminations of pregnancy, intrauterine death, sudden unexpected infant death and identification issues.

Retrograde cerebral venous air embolism: a rare cause of intracranial gas.

The emergency department requested a head computed tomography (CT) without contrast media for a brain trauma (fall from height) in a 92-year-old female patient followed for Alzheimer’s disease. The patient presented an acute confusional status but neurological examination was considered to be normal. Head CT detected several intracranial bubbles of air density. They were mainly right-sided, at the contact of orbital fissure and jugular foramen (Fig. 1). A careful bone window examination was not able to identify any fracture of the vault or base of the skull. Analysis of the topography of the gas bubbles found them all within venous structures: right cavernous sinus and right inferior ophthalmic vein, left cavernous sinus and right sigmoid sinus. Moreover, the CT technologist reported that the patient ripped out her peripheral venous catheter, inserted at the crook of her right elbow, immediately before the examination. The final diagnosis was therefore retrograde venous air embolism. i s v i

Postmortem Whole Body CT Angiography Using Aqueous Contrast Agent

In modern postmortem imaging, the visualization of the vascular system by postmortem angiography is mostly done using multidetector computed tomography (CT). Like clinical radiologic investigations, whole body angiography makes the vascular system visible and allows identification of vascular lesions such as traumatic dissection or rupture. Additionally, the injection of contrast agent enhances soft tissue and aids in the visualization of lesions in organ parenchyma. In this chapter, we describe two methods of whole body postmortem CT angiography (PMCTA) that can be classed in the category of “PMCTA using aqueous contrast agent.”