Histological artifacts induced by the contrast agent in Multi-Phase Post-Mortem CT Angiography (MPMCTA): Part I - Normal Tissues

Introduction: Multiphase postmortem computed tomographic angiography (MPMCTA) is a technique that provides comprehensive visualization of the cardiovascular system by injection of a contrast agent into the cadaver. Our aim is to systematically describe the histo-morphological changes and artifacts induced by the injection of the mixture of contrast agents (Angiofil® and paraffin oil) used for MPMCTA. Materials and methods: Histological specimens taken from 37 cases undergoing MPMCTA and autopsy were analyzed. Histological sections were analyzed using a Semi-motorized Olympus BX53 microscope associated with Olympus DP21 camera for images acquisition, in consecutive reading sessions by three forensic pathologists with experience in the field of histopathology for 20 years. Results: A total of 278 histological samples was included in the study. Different types of artifacts were encountered, which can be grouped into four main categories: the presence of optical empty spaces; the compression of surrounding structures; hyperaemia of small vessels and capillaries; vessel dilation. Conclusions: Postmortem angiography is a valuable method for visualizing blood vessels. However, the use of contrast media can introduce histological artifacts. This potential impact should be carefully considered when deciding whether to perform the procedure.