What is PMA about?

Multi-detector computed tomography (MDCT) is the most widespread tool in modern forensic radiology. Thanks to a short examination time, high spatial resolution, and the possibility of reconstructions in different axes and two and three dimensions, it is an excellent method for rapidly examining a whole body and performing a first analysis of lesions. In clinical radiology, the sensitivity of MDCT can be increased by injecting contrast agent and enhancing the obtained images, leading to better visualization of organ tissues and visualization of the vascular system. This clinical experience inspired researchers in postmortem imaging to start investigating the possibility of performing postmortem MDCT angiography. Similar to the clinical experience, the aim is to increase the sensitivity of postmortem computed tomography (PMCT) and allow investigation of the vascular system, which is often complex to examine in conventional autopsy, especially if small vessels are to be investigated. However, the application of contrast agent postmortem is challenging and differs from clinical angiography, in particular because of the absence of cardiovascular circulation and postmortem changes in the body. Although there are multiple classic methods for performing postmortem angiography, they cannot simply be transferred to modern forensic imaging because they are primarily feasible only on single organs or on embryos and fetuses. Therefore, to overcome these problems, different approaches have been developed for performing modern, minimally invasive PMCT angiography (PMCTA). Once such a technique is established, questions arise about how to interpret the obtained images because they differ from clinical angiography images. Additionally, the injection of contrast medium into a body that is associated with a medico-legal or forensic investigation implies the question of eventual alteration of the results of further analyses that are normally performed in such cases. In the chapter 6 of the « Atlas of Postmortem Angiography », you will find more explanation about the meaning of PMCTA and the challenges encountered in establishing methods that are applicable in legal medicine and a short overview of the most frequently used techniques in modern forensic imaging.

This text is part of the « Atlas of Postmortem Angiography », Springer 2016