By Karoline Teixeira
Photos ASA 400 Studio
When we talk about the use of post-mortem images, we immediately think of forensic case evaluation. Over time, however, its use has expanded to include several other applications, such as supporting the diagnosis and definition of deaths due to natural causes, and is an excellent resource for guiding minimally invasive autopsy procedures.
Thinking about this field of radiology, which is increasingly gaining ground as an essential tool for understanding and defining causes of death, the Post-Mortem Course, a first for JPR, was held on the morning of May 1st.
Coordinated and moderated by Dr. Luiz Fernando Ferraz da Silva, the meeting featured lectures by professors Ellison Fernando Cardoso (also moderator), John Robert Pires Davidson and Ellison Fernando Cardoso, as well as five international speakers, Silke Grabherr (Switzerland), Virginie Magnin (Switzerland), Florian Fischer (Germany), Krzysztof Jerzy Woźniak (Poland) and Gina Maria Bruch (Germany).
Prof. John began the course by discussing post-mortem computed tomography, discussing the differences in assessment compared to in vivo CT. According to him, forensic radiology is an essential and expanding specialty, and post-mortem CT and MRI are important tools to complement open autopsies, which can reduce diagnostic errors.
Along the same lines, Prof. Ellison explained the potential of post-mortem exams for advancement in neuroradiology. At the end of his presentation, he brought some conclusions on the subject – among them, the improvement in the accuracy of the cause of death from neuroimaging in the autopsy room.
Post-Mortem CT Angio gains ground in forensic radiology
In the third class, participants were able to attend a lecture by the pioneer and developer of the post-mortem angiotomography technique, Professor Silke Grabher, who presented the state of the art in the use of this tool. She went through the classic methods to discuss the problems faced and showed the different approaches of modern methods.
For Dr. Ludmila Santiago, who works at the Instituto Médico Legal de São Paulo and recently in forensic radiology, it is very important to have this course at the Jornada Paulista de Radiologia: “I am glad the event opened this space; learning from the speakers was fantastic. I loved meeting Dr. Silke, who is a pioneer in this evaluation methodology. The topic is here to stay; we currently do this at the Instituto Médico Legal, however, only with simple tomography, without the use of contrast. In other words, exchanging experiences with the professors of this course was enriching.”
Within the theme of CT angiography, Prof. Virginie Magnin spoke about the radiological interpretation of post-mortem CT angiography; then, Prof. Florian Fischer explained the dynamics, flow and possibilities of reconstruction, while Prof. Krzysztof Jerzy Woźniak taught the class “Targeted CT angiography: Assessment of deaths not related to medical errors”. And, to conclude, Prof. Gina Maria Bruch addressed CT and post-mortem CT angiography in pediatric cases.
The professors emphasized that post-mortem angiography is not the same as when performed during life; hence the importance of these classes, so that the professional knows how to perform and evaluate it correctly and accurately.
Course participant, Dr. Simone Maluf Barella, coordinator of interventional radiology at HAPVida Intermédica, said she was surprised to learn that post-mortem CT angiography has already being performed in Brazil: “I found this part of the lecture very interesting. We don’t have much contact with post-mortem tomography, and this technique is becoming more common every day. Unfortunately, there are cases of medical errors and deaths in hospitals whose cause is unknown, so having a course focused on this knowledge and learning on such a large scale as JPR is fantastic.”
Check out the testimony of one of the participants and the course coordinator, Dr. Luiz Fernando:
