To see or not to see -- ambiguous findings on post-mortem cross-sectional imaging in a case of ruptured abdominal aortic aneurysm

Leg Med (Tokyo). 2013 Sep;15(5):256-9. doi: 10.1016/j.legalmed.2013.03.001. Epub 2013 Apr 19.

Abstract

We present a case of a ruptured abdominal aortic aneurysm (AAA) with ambiguous accessory findings on post-mortem computed-tomography (PMCT), post-mortem magnetic resonance (PMMR) imaging, and PMCT-angiography (PMCTA) suggestive of thoracic aortic dissection. The diagnosis of ruptured AAA was confirmed by autopsy; however, there was no aortic dissection. The imaging findings that mimicked the presence of aortic dissection might have been an atypical presentation of post-mortem clotting or sedimentation. This case is an ideal example to illustrate benefits, limitations, and challenges of post-mortem cross-sectional imaging. It serves as a reminder that both, training as well as correlation of imaging findings with autopsy are fundamental to improve our understanding of radiologic findings on post-mortem cross-sectional imaging.

Keywords: Aortic dissection; Forensic radiology; Post-mortem CT; Post-mortem CT-angiography; Post-mortem MR; Ruptured aortic aneurysm; Virtopsy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiography
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / pathology*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / pathology*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / pathology*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / pathology*
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / pathology
  • Autopsy
  • Diagnosis, Differential
  • Diagnostic Imaging / methods*
  • Forensic Pathology / methods*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Plaque, Atherosclerotic / diagnostic imaging*
  • Plaque, Atherosclerotic / pathology
  • Tomography, X-Ray Computed