Postmortem Computed Tomography Angiography of Newborns
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Tomography Angiography of Newborns U. N. Tumanova, V. M. Lyapin, V. G. Bychenko, A. I. Shchegolev, and G. T. Sukhikh
Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 170, No. 8, pp. 248-255, August, 2020 Original article submitted May 7, 2020 We propose an original method of postmortem computed tomography angiography of the body of a deceased newborn. The work is based on the analysis of the results of comprehensive postmortem computed tomography and pathological examination of 30 newborns, who died from congenital malformations. The key to a full-fledged postmortem radiation study using intravascular contrasting of deceased newborns and infants is the presence of vascular catheters established during life, as well as conducting it no earlier than 12 h and no later than 48 h after death. As a contrast agent, we recommend to use an iodine-containing water-soluble radiopaque drug containing at least 250 mg of iodine per 1 ml. The volume of contrast agent is calculated based on body weight, taking into account the general edema syndrome. The introduction of a contrast agent is carried out through vascular catheters in 3 stages in various positions of the body. The analysis of tomograms and 3D-reconstruction of blood vessels using their pseudocoloring allows accurate assessment of the topography of blood vessels with the possibility of separate study of the arterial and venous vessels, and to identify both congenital abnormalities of the heart and blood vessels, and their acquired pathology. CT angiography in some cases is superior to traditional autopsy in the diagnosis of blood vessel pathology. Postmortem CT angiography should be considered as an important stage of postmortem radiology in the structure of comprehensive pathological analysis of newborns and infants. Key Words: newborn; computed tomography (CT); angiography; virtopsy Congenital heart and vascular malformations are among the most frequent and severe developmental abnormalities. According to the Federal State Statistics Service of Russia, abnormalities of the circulatory system take the third place among all congenital malformations as a cause of stillbirth and the first place — in observations of early neonatal death [4,7]. In case of a fatal outcome, verification and determination of a specific type of defect is carried out based on the data from autopsy. However, autopsy of dead fetuses and dead newborns is difficult due to small size of organs, low strength of tissues and vessels, and the need to take into account the degree of maturity. Moreover, according to published data V. I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, Moscow, Russia. Address for correspondence: u.n.tumanova@ gmail.com. U. N. Tumanova
[13], the number of refusals to perform autopsies for religious, sociocultural, deontological and economic reasons is constantly increasing. Computed tomography angiography (CTA) is considered the main method in clinical practice for diag
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