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Postmortem CT angiography of fetuses, infants and children up to 12 years old a systematic review and conceptual decision tree.

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Bibliographic Details
Title: Postmortem CT angiography of fetuses, infants and children up to 12 years old a systematic review and conceptual decision tree.
Authors: Vanhaebost, J., Scholzen, T., Coche, E., Grabherr, S.
Publication Year: 2025
Collection: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Subject Terms: Fetal imaging, Pmcta, PedPMCTA, Pediatric imaging, Postmortem imaging
Description: Postmortem CT angiography (PMCTA) enhances traditional autopsy by enabling detailed visualization of vascular structures and sources of hemorrhage. However, its application in fetuses and children remains limited due to small vessel size and the lack of standardized techniques. This systematic review critically evaluates existing literature on PMCTA in decedents under 12 years old, with the aim of identifying current practices and methodological variations to assist practitioners in selecting appropriate protocols based on age and anatomical characteristics. A systematic literature research was conducted following PRISMA guidelines using PubMed, Scopus, Embase and Google Scholar from 2004 to 2024. Eligible articles investigated PMCTA in fetuses and children up to 12 year old. Extracted data covered technical protocols, vascular access, contrast preparation, perfusion parameters and imaging outcomes. A decision tree was constructed to illustrate potential approaches by age group and anatomical features. Ten studies met inclusion criteria: five focused on fetal PMCTA, four on children, and one on both populations. Considerable heterogeneity was found across protocols, especially regarding contrast media preparation and injection techniques. A conceptual decision tree was developed based on reported practices. This framework is not a validated algorithm and should be applied cautiously, with attention to individual anatomical and contextual factors. This review underscores the lack of standardized fetal and pediatric PMCTA protocols. It offers structured guidance while highlighting the need for further research to develop and validate consistent approaches in this vulnerable population.
Document Type: article in journal/newspaper
Language: English
ISSN: 1437-1596
Relation: International Journal of Legal Medicine; https://iris.unil.ch/handle/iris/273105; serval:BIB_9A793AD09849; 001522681100001
DOI: 10.1007/s00414-025-03556-5
Availability: https://iris.unil.ch/handle/iris/273105
https://doi.org/10.1007/s00414-025-03556-5
Accession Number: edsbas.548F79B8
Database: BASE
Description
Abstract:Postmortem CT angiography (PMCTA) enhances traditional autopsy by enabling detailed visualization of vascular structures and sources of hemorrhage. However, its application in fetuses and children remains limited due to small vessel size and the lack of standardized techniques. This systematic review critically evaluates existing literature on PMCTA in decedents under 12 years old, with the aim of identifying current practices and methodological variations to assist practitioners in selecting appropriate protocols based on age and anatomical characteristics. A systematic literature research was conducted following PRISMA guidelines using PubMed, Scopus, Embase and Google Scholar from 2004 to 2024. Eligible articles investigated PMCTA in fetuses and children up to 12 year old. Extracted data covered technical protocols, vascular access, contrast preparation, perfusion parameters and imaging outcomes. A decision tree was constructed to illustrate potential approaches by age group and anatomical features. Ten studies met inclusion criteria: five focused on fetal PMCTA, four on children, and one on both populations. Considerable heterogeneity was found across protocols, especially regarding contrast media preparation and injection techniques. A conceptual decision tree was developed based on reported practices. This framework is not a validated algorithm and should be applied cautiously, with attention to individual anatomical and contextual factors. This review underscores the lack of standardized fetal and pediatric PMCTA protocols. It offers structured guidance while highlighting the need for further research to develop and validate consistent approaches in this vulnerable population.
ISSN:14371596
DOI:10.1007/s00414-025-03556-5