{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T15:37:52Z","timestamp":1792856272789,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:00Z","timestamp":1792800000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:00:00Z","timestamp":1792800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen","id":[{"id":"https:\/\/ror.org\/05591te55","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Legal Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The primary objective of this study was to evaluate the influence of perfusion pressure in postmortem computed tomography angiography (PMCTA) on the visualisation of the coronary arteries. Coronary artery disease is a frequent cause of sudden cardiac death, and PMCTA is used alongside autopsy to assess the coronary arteries, including bypass grafts and stents. Reliable opacification of the coronary arteries is required to identify stenoses and acute occlusions and to assess their contribution to the mechanism of death. However, contrast distribution in PMCTA varies between cases, and perfusion-related artefacts can limit interpretation. Perfusion pressure is one parameter that can be controlled. An important step in this direction has been the recent demonstration that perfusion pressure can be continuously monitored during PMCTA. In this study of twelve postmortem cases (six evaluable), we examined three intravascular pressure groups (40, 60, and 80 mmHg) to assess coronary artery visualisation using a modified contrast agent pump with coupled real-time pressure monitoring and control. In this pilot study, 60 mmHg was the lowest perfusion pressure at which homogeneous coronary opacification with minimal perfusion-related artefacts was observed in all evaluable cases (two cases per pressure group). In one case a perfusion pressure of 80 mmHg depicted the peripheral coronary branches more completely, an observation that requires confirmation in a larger cohort. These findings may contribute to the methodological standardisation of pressure-based PMCTA protocols in forensic practice.<\/jats:p>","DOI":"10.1007\/s00414-026-04050-2","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:17:29Z","timestamp":1792808249000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of perfusion pressure on image quality in postmortem CT angiography (PMCTA) of coronary arteries: a pilot study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0132-5147","authenticated-orcid":false,"given":"Ngoc Huyen-Chau","family":"Feldmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian O.","family":"Sabel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina Maria","family":"Bruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian Tobias","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,24]]},"reference":[{"key":"4050_CR1","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1080\/20961790.2019.1630944","volume":"4","author":"K Michaud","year":"2019","unstructured":"Michaud K, Genet P, Sabatasso S, Grabherr S (2019) Postmortem imaging as a complementary tool for the investigation of cardiac death. Forensic Sci Res 4:211\u2013222. https:\/\/doi.org\/10.1080\/20961790.2019.1630944","journal-title":"Forensic Sci Res"},{"key":"4050_CR2","doi-asserted-by":"publisher","first-page":"e76","DOI":"10.1016\/j.forsciint.2013.01.039","volume":"228","author":"L Filograna","year":"2013","unstructured":"Filograna L, Hatch G, Ruder T et al (2013) The role of post-mortem imaging in a case of sudden death due to ascending aorta aneurysm rupture. Forensic Sci Int 228:e76\u2013e80. https:\/\/doi.org\/10.1016\/j.forsciint.2013.01.039","journal-title":"Forensic Sci Int"},{"key":"4050_CR3","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1007\/s00414-010-0526-5","volume":"125","author":"S Grabherr","year":"2011","unstructured":"Grabherr S, Doenz F, Steger B et al (2011) Multi-phase post-mortem CT angiography: development of a standardized protocol. Int J Legal Med 125:791\u2013802. https:\/\/doi.org\/10.1007\/s00414-010-0526-5","journal-title":"Int J Legal Med"},{"key":"4050_CR4","doi-asserted-by":"publisher","first-page":"345","DOI":"10.2214\/AJR.07.2261","volume":"190","author":"S Grabherr","year":"2008","unstructured":"Grabherr S, Gygax E, Sollberger B et al (2008) Two-Step Postmortem Angiography with a Modified Heart\u2013Lung Machine: Preliminary Results. Am J Roentgenol 190:345\u2013351. https:\/\/doi.org\/10.2214\/AJR.07.2261","journal-title":"Am J Roentgenol"},{"key":"4050_CR5","doi-asserted-by":"publisher","first-page":"961","DOI":"10.3390\/tomography8020077","volume":"8","author":"C Stassi","year":"2022","unstructured":"Stassi C, Mondello C, Baldino G et al (2022) State of the Art on the Role of Postmortem Computed Tomography Angiography and Magnetic Resonance Imaging in the Diagnosis of Cardiac Causes of Death: A Narrative Review. Tomography 8:961\u2013973. https:\/\/doi.org\/10.3390\/tomography8020077","journal-title":"Tomography"},{"key":"4050_CR6","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1007\/s10554-012-0012-x","volume":"28","author":"K Michaud","year":"2012","unstructured":"Michaud K, Grabherr S, Doenz F, Mangin P (2012) Evaluation of postmortem MDCT and MDCT-angiography for the investigation of sudden cardiac death related to atherosclerotic coronary artery disease. Int J Cardiovasc Imaging 28:1807\u20131822. https:\/\/doi.org\/10.1007\/s10554-012-0012-x","journal-title":"Int J Cardiovasc Imaging"},{"key":"4050_CR7","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/s00414-017-1652-0","volume":"132","author":"R Troxler","year":"2018","unstructured":"Troxler R, Minoiu C, Vaucher P et al (2018) The role of angiography in the congruence of cardiovascular measurements between autopsy and postmortem imaging. Int J Legal Med 132:249\u2013262. https:\/\/doi.org\/10.1007\/s00414-017-1652-0","journal-title":"Int J Legal Med"},{"key":"4050_CR8","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1093\/fsr\/owad038","volume":"8","author":"L Wan","year":"2023","unstructured":"Wan L, Chen J, Zhou Z et al (2023) The value of PMCTA in the diagnosis of coronary atherosclerosis in isolated human hearts. Forensic Sci Res 8:308\u2013312. https:\/\/doi.org\/10.1093\/fsr\/owad038","journal-title":"Forensic Sci Res"},{"key":"4050_CR9","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1080\/20961790.2017.1328795","volume":"2","author":"L Wan","year":"2017","unstructured":"Wan L, Shao Y, Zou D et al (2017) Diagnosis of coronary artery disease using targeted post-mortem computed tomography coronary angiography: a case report. Forensic Sci Res 2:107\u2013111. https:\/\/doi.org\/10.1080\/20961790.2017.1328795","journal-title":"Forensic Sci Res"},{"key":"4050_CR10","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1148\/rg.343115169","volume":"34","author":"SG Ross","year":"2014","unstructured":"Ross SG, Bolliger SA, Ampanozi G et al (2014) Postmortem CT Angiography: Capabilities and Limitations in Traumatic and Natural Causes of Death. Radiographics 34:830\u2013846. https:\/\/doi.org\/10.1148\/rg.343115169","journal-title":"Radiographics"},{"key":"4050_CR11","doi-asserted-by":"publisher","first-page":"832","DOI":"10.2214\/AJR.06.0787","volume":"188","author":"S Grabherr","year":"2007","unstructured":"Grabherr S, Djonov V, Yen K et al (2007) Postmortem Angiography: Review of Former and Current Methods. Am J Roentgenol 188:832\u2013838. https:\/\/doi.org\/10.2214\/AJR.06.0787","journal-title":"Am J Roentgenol"},{"key":"4050_CR12","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1007\/s00414-023-02999-y","volume":"137","author":"C Egger","year":"2023","unstructured":"Egger C, Wiskott K, Vaucher P et al (2023) Post-mortem changes of the vascular system-a thanatological study using multidetector computed tomography. Int J Legal Med 137:1109\u20131115. https:\/\/doi.org\/10.1007\/s00414-023-02999-y","journal-title":"Int J Legal Med"},{"key":"4050_CR13","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1520\/JFS2005023","volume":"50","author":"C Jackowski","year":"2005","unstructured":"Jackowski C, Sonnenschein M, Thali MJ et al (2005) Virtopsy: postmortem minimally invasive angiography using cross section techniques\u2013implementation and preliminary results. J Forensic Sci 50:1175\u20131186","journal-title":"J Forensic Sci"},{"key":"4050_CR14","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1007\/s00414-013-0840-9","volume":"127","author":"C Bruguier","year":"2013","unstructured":"Bruguier C, Mosimann PJ, Vaucher P et al (2013) Multi-phase postmortem CT angiography: recognizing technique-related artefacts and pitfalls. Int J Legal Med 127:639\u2013652. https:\/\/doi.org\/10.1007\/s00414-013-0840-9","journal-title":"Int J Legal Med"},{"key":"4050_CR15","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1148\/radiol.2018170559","volume":"288","author":"S Grabherr","year":"2018","unstructured":"Grabherr S, Heinemann A, Vogel H et al (2018) Postmortem CT Angiography Compared with Autopsy: A Forensic Multicenter Study. Radiology 288:270\u2013276. https:\/\/doi.org\/10.1148\/radiol.2018170559","journal-title":"Radiology"},{"key":"4050_CR16","doi-asserted-by":"publisher","first-page":"20130488","DOI":"10.1259\/bjr.20130488","volume":"87","author":"S Grabherr","year":"2014","unstructured":"Grabherr S, Grimm J, Dominguez A et al (2014) Advances in post-mortem CT-angiography. BJR 87:20130488. https:\/\/doi.org\/10.1259\/bjr.20130488","journal-title":"BJR"},{"key":"4050_CR17","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s11547-015-0574-5","volume":"120","author":"A Heinemann","year":"2015","unstructured":"Heinemann A, Vogel H, Heller M et al (2015) Investigation of medical intervention with fatal outcome: the impact of post-mortem CT and CT angiography. Radiol Med 120:835\u2013845. https:\/\/doi.org\/10.1007\/s11547-015-0574-5","journal-title":"Radiol Med"},{"key":"4050_CR18","volume-title":"Weiterentwicklung der postmortalen mehrphasigen Computertomographie-Angiographie (PMCTA): Physiologie der postmortalen Kontrastmittelperfusion","author":"FT Fischer","year":"2024","unstructured":"Fischer FT (2024) Weiterentwicklung der postmortalen mehrphasigen Computertomographie-Angiographie (PMCTA): Physiologie der postmortalen Kontrastmittelperfusion. Habilitationsschrift, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Medizinische Fakult\u00e4t"},{"key":"4050_CR19","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1007\/s00414-025-03461-x","volume":"139","author":"F Dedouit","year":"2025","unstructured":"Dedouit F, Ducloyer M, Elifritz J et al (2025) The current state of forensic imaging - post mortem imaging. Int J Legal Med 139:1141\u20131159. https:\/\/doi.org\/10.1007\/s00414-025-03461-x","journal-title":"Int J Legal Med"},{"key":"4050_CR20","doi-asserted-by":"publisher","first-page":"2131","DOI":"10.1007\/s00414-026-03750-z","volume":"140","author":"J Vanhaebost","year":"2026","unstructured":"Vanhaebost J, Tr\u00e4chsel B, Fischer FT et al (2026) Postmortem CT angiography in infants and young children (pedPMCTA): Technical feasibility and emerging forensic insights from a 30-case study. Int J Legal Med 140:2131\u20132141. https:\/\/doi.org\/10.1007\/s00414-026-03750-z","journal-title":"Int J Legal Med"},{"key":"4050_CR21","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1002\/jemt.20585","volume":"71","author":"S Grabherr","year":"2008","unstructured":"Grabherr S, Hess A, Karolczak M et al (2008) Angiofil-mediated visualization of the vascular system by microcomputed tomography: a feasibility study. Microsc Res Tech 71:551\u2013556","journal-title":"Microsc Res Tech"},{"key":"4050_CR22","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s11547-016-0698-2","volume":"122","author":"J Vanhaebost","year":"2017","unstructured":"Vanhaebost J, Ducrot K, De Froidmont S et al (2017) Diagnosis of myocardial ischemia combining multiphase postmortem CT-angiography, histology, and postmortem biochemistry. Radiol med 122:95\u2013105. https:\/\/doi.org\/10.1007\/s11547-016-0698-2","journal-title":"Radiol med"}],"container-title":["International Journal of Legal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-04050-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-026-04050-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00414-026-04050-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T15:02:06Z","timestamp":1792854126000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00414-026-04050-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,24]]},"references-count":22,"alternative-id":["4050"],"URL":"https:\/\/doi.org\/10.1007\/s00414-026-04050-2","relation":{},"ISSN":["0937-9827","1437-1596"],"issn-type":[{"value":"0937-9827","type":"print"},{"value":"1437-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,24]]},"assertion":[{"value":"5 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}