The use of injected contrast agents in cadaveric CT

Outline of Research Proposal for MD

Dr Sarah Saunders

 

TITLE:           The use of injected contrast agents in cadaveric CT.

Supervisors:

Dr Bruno Morgan

Professor Guy Rutty

Background to the Project:

In recent years there has been increasing interest in the use of CT scanning as a replacement or adjunct to autopsy. Investigations into the possible use of CT and MRI have increased recently.  Internationally this has led to the instalment of CT scanners into mortuaries, such as the Victorian Institute of Forensic Medicine, Australia.  However publications in this field remain mainly anecdotal.

One of the main weaknesses of post mortem CT is that the commonest causes of death in the UK relate to coronary artery disease, stroke and pulmonary embolus. These are best visualised by CT with the use of contrast media.  Contrast enhanced CT is also crucial in the investigation of trauma victims.  This presents a problem for post mortem CT, as standard clinical contrast enhanced CT relies on blood circulation.

A practical means of imaging the coronary arteries and other vessels of the body would therefore overcome one of the major deficiencies to cadaveric CT imaging. The feasibility of post mortem CT angiography has been established in humans, and since 2005 six papers have been published related to cadaver contrast enhanced CT imaging, 3 in animals and 3 in humans with the largest involving 10 cadavers using a heart-lung machine to administer contrast.  However to date, there remains no simple and achievable method for this technique for large scale imaging of cadavers within the NHS.

We propose the development of a practical CT angiographic technique for large scale implementation of cadaveric CT scanning.

Hypothesis:

This project will address the potential use of iodinated contrast for post mortem CT.  The hypothesis is that by using a combination of embalming and interventional radiological techniques, specific CT angiograms can be performed of the great vessels, coronary, cerebral or pulmonary circulations.  The project will also test whether these contrast enhanced scans can provide a quick, affordable and practical alternative to invasive autopsy in certain patient groups. 

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