Comparative analysis of artery anatomy evaluated by post mortem tomography, CT angiography post mortem and pre-death CT scans.

INTRODUCTION To date, no study has been performed analyzing changes in the vascular system comparing paired examinations of patients alive and after death with the use of cardiopulmonary bypass and CT angiography. MATERIALS AND METHODS The aim of this study was to analyze in a large series (38 patients) the aorta and its branches by CT (without contrast) and CT angiography of patients still alive and after death comparing their diameters and length variations. RESULTS The variation between in vivo tomography and virtopsy methods was greater in the evaluation of distances between vascular segments than in the diameters, less than 30% of the distances evaluated in the entire study had acceptable variation between methods, regardless of the use of contrast scans. We observed better repeatability rates in the comparison between in vivo and postmortem contrast-enhanced examinations. Comparing the examinations of the still alive individuals with the contrast-enhanced tomography after death, we observed a higher concordance rate. The best variations between the methods were observed in the evaluation of the diameters in the contrast-enhanced examination of the ascending aorta, aortic arch, thoracic aorta and thoracoabdominal transition. CONCLUSION The measurements obtained in post-mortem angiography images partially reflect the vascular anatomy of the main branches in the thoracoabdominal region in vivo. However, post-mortem computed tomography without contrast did not performed in the same comparison. We believe that adjustments to the contrast injection technique may eventually improve these results.