食管癌浸润深度的CT与病理探索

目的:探索30例中晚期食管鳞癌患者外侵与转移时CT表现,为临床正确估价食管癌手术切除的可能性,术式的选择和开展综合治疗提供CT方面的诊断依据。方法:对30例食管癌患者的CT片和术后标本进行了观察。结果:(1)当食管壁厚≤1cm时,癌多限于壁内浸润;而壁厚达2cm时其外侵率高达51%,3cm时外侵率达79%;>3cm者外侵率达100%。(2)在接触范围中,大于1/4周径与小于1/4周径受侵率明显不同。(3)中上段食管癌较易侵及气管、支气管,引起其形态方面的改变,陷入型受侵率可达75%。结论:CT可在术前正确判断肿瘤切除的可能性,可使部分食管癌患者避免不必要的剖胸探查。

甲状腺良恶性病变的CT表现及其病理结果对比研究

目的分析甲状腺良恶性病变的CT表现及其病理结果关联性。方法回顾性分析我院2016年10月～2017年10月经手术病理证实的57例甲状腺良性肿瘤患者以及23例恶性肿瘤患者的临床资料,并对其术前CT表现与手术病理结果进行比较分析。结果 57例良性病变患者中,单侧发病占比70.18%(40/57),双侧发病占比29.82%(17/57),病灶总数为80个。23例恶性病变患者中,单侧发病占比95.65%(22/23),双侧发病占比4.35%(1/23),病灶总数为24个。边界不清、钙化发生率及囊性变发生率比较,良性病变者均明显低于恶性病变者,差异有统计学意义(P<0.05);恶性病变的强化程度、甲状腺包膜不完整性及淋巴转移发生率均高于良性病变,差异有统计学意义(P<0.05)。结论通过CT对甲状腺良恶性病变进行判断时,要依据病变密度、边界、钙化情况以及囊变情况、强化特征、包膜的完整性及周围淋巴结肿情况进行综合判断,有助于对疾病做出正确的鉴别与诊断。

节细胞神经瘤CT与病理对照分析（附11例报道）

目的通过CT与病理对照分析，探讨CT在诊断节细胞神经瘤中诊断价值，以提高CT对该病定性准确率。方法随机抽取2005年6月-2006年6月间经手术病理证实节细胞神经瘤病例总计11例，并对其CT影像、CT诊断回顾性性分析、总结。结果11例患者中，CT诊断与病理结果符合者仅5例，误诊6例。结论节细胞神经瘤临床无特异性症状，CT缺乏特征性表现，误诊率较高。根据肿瘤好发部位、病变密度、钙化及增强后表现，认真、细致观察，可提高该病定性准确率。

原发性食管神经内分泌癌影像学及病理特征

目的:探讨原发性食管神经内分泌肿瘤的病理特征及临床诊断模式。方法:回顾性分析2001年1月至2010年12月在本科接受治疗的32例原发性食管神经内分泌癌的临床影像学诊断方法、病理特征。结果:32例原发性食管神经内分泌癌中,小细胞癌27例(84.38%,27/32),不典型类癌4例(12.5%,4/32),类癌1例(3.13%,1/32);影像学(螺旋CT或PET/CT检查)评估可手术患者的临床TNM分期(TNM staging),手术后病理TNM分期(Pathological TNM staging,pTNM分期)上调的占本组患者总数的12.5%(4/32),主要为3例术前评估为T_3的患者术中见为侵犯外膜(T_4),另1例术前为T_2NOMO患者术后有单站纵隔淋巴结转移(N1);免疫组化提示肿瘤细胞表达嗜铬素A(CgA)、肿瘤细胞表达突触素(Syn)、神经特异性烯醇化酶(NSE)等单种或多种分化标记物呈阳性表达。结论:原发性食管神经内分泌癌特别是小细胞癌恶性程度高,综合多部位的增强CT或PET/CT等多种影像学检查手段有助于临床分期,病理检查中联合CgA、Syn、NSE等多种分子标记有助于明确诊断。

Cavitary Pulmonary Metastases: CT Features and Their Correlation with the Pathology of the Primary Malignancy

Objective: To study CT features of cavitary pulmonary metastases and to investigate the pos- sible relationship between CT features and the pathology of the primary lesions. Methods: CT ?ndings of 131 cavitary metastatic nodules in 40 patients with pathologically-proved pulmonary metastases were retrospectively analyzed. A comparison between CT signs and the pathologic types of the primary tumors was made. Results: Cavitary metastases and multiple solid nodules coexisted in all patients. Cavitary metastases presented as bubble (n=41), irregular (n=33), cystic (n=26) or small circular (n=31) cavities, with even (n=61) or uneven (n=70) thickness of the cavity wall. Of 131 cavitary nodules, diameter less than 15 mm was seen in 44, between 15–25 mm in 66, 25–40 mm in 17 and larger than 40 mm in 4 respectively. And the wall thickness of the cavity below 4 mm, between 4–15 mm and over 15 mm was respectively seen in 69, 44 and 18 metastatic nodules. Cavitary pulmonary metastases mainly occurred in patients whose primary malignancy was squamous cell carcinoma (n=13) or adenocarcinoma (n=22). Both squamous cell carcinoma and adenocarcinoma had its own CT characteristics. The occurrence of cavity bore no relationship to its site in the lung. Conclusion: Cavitary pulmonary metastases carries certain CT features and its occurrence is related to the pathologic type of the primary malignancy.

Pathological and High Resolution CT Findings in Churg-Strauss Syndrome

Objective To investigate the Churg-Strauss syndrome （CSS） associated lung involvement, concentrating on clinical characteristics, pathological findings of tung involvements, response to treatment, and prognosis. Methods We retrospectively analyzed the characters of the clinical manifestations, thin-section CT and pathological findings of CSS. The study involved 16 patients. Clinical data were obtained by chart review All patients underwent transbronchial lung biopsy （TBLB）. Six of them underwent surgical lung biopsy as well. Results The patients included 7 men and 9 women, aged from 14 to 61 years （median, 47.5 years）. Extrathoracic organs involved included nervous system （7/16） and skin （5/16）. Respiratory symptoms included cough （12/16）, exertional dyspnea （11/16）, hemoptysis （4/16）, and chest pain （3/16）. CT findings included bilateral ground-glass opacities （12 / 16）, bilateral patchy opacities （12 / 16）, and centrilobular nodules （6/16）. The pathological findings of TBLB demonstrated increased eosinophils （3/16）, vasculitis （3/16）, and interstitial pneumonia （16/16）. The pathological fmdings of surgical lung biopsy of 6 cases showed necrotizing vasculitis in 4 cases, capillaries in 5, eosinophilic pneumonia in 3, granulomas in 2, and airway abnormalities in 3. All patients improved in symptoms after therapy during the study period （range, 3 to 51 months; median, 15 months）. Conclusions Asthma may be present in CSS patient when there is bronchial involvement. Grotmd-glass opacities and consolidation seen on high-resolution CT reflect the presence of eosinophilic pneumonia, vasculitis, and pulmonary alveolar hemorrhage. TBLB has significant limitations for the diagnosis of CSS. Early diagnosis and therapy can result in satisfactory prognosis.

Hepatic schwannoma:Imaging findings on CT,MRI and contrast-enhanced ultrasonography

A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preoperatively diagnosing a benign liver schwannoma.A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver.A malignant tumor was suspected,and a right hepatectomy was performed.After this,the diagnosis of a primary benign schwannoma of the liver was made through pathological examination.Contrast-enhanced ultrasonography(CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase;most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells.In the postvascular phase,CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas;most likely due to aggregation of siderophores.Because discriminating between a benign and malignant schwannoma of the liver is difficult,surgery is generally recommended.However,the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores.

Evaluation of contrast-enhanced helical hydro-CT in staging gastric cancer

AIM： TO discuss the helical computed tomography （CT） characteristics of gastric cancer and evaluate the diagnostic value of contrast-enhanced helical hydro-CT （HHCT） in staging gastric cancer. METHODS： A total of 50 patients with gastric cancer were included in this study. The CT findings in them were retrospectively analyzed and correlated with pathologic findings at surgery. All patients were preoperatively imaged by plain and contrast-enhanced helical CT afer orally ingesting 1 000-1 500 mL water. Peristalsis was minimized by intravenous administration of spasmolytics. RESULTS： The foci of gastric cancer became more prominent in all the 50 patients and showed strong enhancement in contrast-enhanced HHCT. The tumor was located at the gastric cardia in 14 cases, at the gastric fundus in 3 cases, at the gastric body in 8 cases, at the gastric antrum in 4 cases, at the gastric fundus and the body in 8 cases, at the gastric body and antrum in 11 cases, and at three segments of the stomach in 2 cases. The CT features of gastric cancer were focal or diffuse mural thickening, soft tissue mass, cancerous ulcer, stenosis of stomach, infiltration to adjacent tissues, lymph node and distant metastases. Strong contrast enhancement of the gastric wall was closely related to gastric cancer. The accuracy rate of contrast-enhanced HHCT in staging gastric cancer was 86% （43/50）. The detection rate of lymph node metastases by CT was 60% （12/20）. CONCLUSION： Contrast-enhanced HHCT is a reliable method to diagnose and stage gastric cancer.

Three-dimensional MR and axial CT colonography versus conventional colonoscopy for detection of colon pathologies

AIM： To evaluate the sensitivity and specificity of MR colonography （MRC） and CT performance in detecting colon lesions, and to compare their sensitivity and specificity with that of conventional colonoscopy. METHODS： Forty-two patients suspected of having colonic lesions, because of rectal bleeding, positive fecal occult blood test results or altered bowel habits, underwent the examinations. After insertion of a rectal tube, the colon was filled with 1000-1500 mL of a mixture of 9 g/L NaCI solution, 15-20 mL of 0.5 mmol/L gadopentetate dimeglumine and 100 mL of iodinized contrast material. Once colonic distension was achieved, three-dimensional gradient-echo （3D-GRE） sequences for MR colonography and complementary MR images were taken in all cases. Immediately after MR colonography, abdominal CT images were taken by spiral CT in the axial and supine position. Then all patients were examined by conventional colonoscopy （CC）. RESULTS： The sensitivity and specificity of MRC for colon pathologies were 96.4% and 100%, respectively. The percentage of correct diagnosis by MRC was 97.6%. The sensitivity and specificity of CT for colon pathologies were 92.8%, 100%, respectively. The percentage of correct diagnosis by CT was 95.2%. CONCLUSION： In detecting colon lesions, MRC achieved a diagnostic accuracy similar to CC. However, MRC is minimally invasive, with no need for sedation or analgesics during investigation. There is a lower percentage of perforation risk, and all colon segments can be evaluated due to multi-sectional imaging availability; intramural, extra-intestinal components of colonic lesions, metastasis and any additional lesions can be evaluated easily. MRC and CT colonography are new radiological techniques that promise to be highly sensitive in the detection of colorectal mass and inflammatory bowel lesions.

Clinical significance of CT-defined minimal ascites in patients with gastric cancer

AIM： To study the clinical significance of minimal ascites, which was only defined by the CT and whose nature was not determined preoperatively, in the relationship with the peritoneal carcinomatosis. METHODS： The medical records and the dynamic CT films of 118 patients with gastric cancer were reviewed. Factors associated with peritoneal carcinomatosis were analyzed in 40 patients who had CT-defined ascites of which the nature was surgically confirmed, RESULTS： Only 12.5-25% of the CT-defined minimal ascites, whose volume was estimated to be less than 50 mL, were associated with peritoneal carcinomatosis. When the estimated CT-defined ascitic volume was 50 mL or more, peritoneal carclnomatosis was identified in 75-100%. When CT-defined lymph node enlargements were not found beyond the regional gastric area, perigastric invasions were not suspected, and the size of tumor was less than 3 cm, peritoneal carcinomatosis seemed significantly less accompanied at the univariate analysis. However, except for the minimal volume of CT- defined ascites in comparison with the mild or more, other factors were not confirmed multivariately. CONCLUSION： In the patients with gastric cancer, CT- defined minimal ascites alone is rarely associated with peritoneal carcinomatosis, if it does not accompany other signs suggestive of malignant seeding. Therefore, consideration of active curative resection should not be hesitated, if CT-defined minimal ascites is the only delusive sign.

肺肉瘤样癌CT诊断与文献回顾

目的探讨肺肉瘤样癌(PSC)CT表现并对相关文献进行回顾。方法回顾性分析陕西省人民医院2015年1月至2020年3月住院诊治的10例PSC患者的CT表现、病理及免疫组化资料。结果10例患者均表现出肺内单发占位性病变,为周围性分布,其中右肺上叶2例,右肺下叶2例,左肺下叶2例,左肺上下叶跨叶生长4例;病灶最大直径10.8 cm,平均直径(5.3±3.7)cm;5例形态不规则,2例周围多发短毛刺,3例病变周围形成大小不等的空洞;增强扫描病变呈轻-中度不均匀强化改变,中央坏死区不强化。免疫组化显示:上皮细胞角蛋白(CK)、波形蛋白阳性7例,上皮细胞膜抗原(EMA)阳性3例。结论PSC在CT平扫及增强图像上具有一些特征表现,可为临床诊断提供帮助,明确诊断需结合病理及免疫组化。

Tumor angiogenesis and dynamic CT in colorectal carcinoma: Radiologic-pathologic correlation

AIM: To investigate the correlation between microvessel density and spiral CT perfusion imaging in colorectal carcinoma. METHODS: Thirty-seven patients, with histologically proven colorectal carcinoma, underwent water enema spiral CT scan. The largest axial surface of the primary tumor was searched on unenhanced spiral CT images. At this level, the enhanced dynamic scan series was acquired. Time-density curves (TDC) were created from the region of interest drawn over the tumor, target artery by Toshiba Xpress/SX spiral CT with perfusion functional software. Then the perfusion was calculated. Microvessel density (MVD) was evaluated using immunohistochemical staining of surgical specimens with anti-CD34, and then MVD was correlated with perfusion. RESULTS: MVD of colorectal carcinomas was 33.11-173.44, mean 87.28, and perfusion was 15.60-64.80 mL/min/ 100 g, mean 39.74 mL/min/100 g. MVD and perfusion were not associated with invasive depth, metastasis and disease stage, and they all decreased with increasing Dukes' stage, but no significant correlation was found between them (r=0.18, P=0.29). CONCLUSION: There is no significant correlation between MVD and perfusion. Neovascularizaton and perfusion are highly presented in early colorectal carcinoma. CT perfusion imaging may be more suited for assessing tumorigenesis in colorectal carcinoma than histological MVD technique.

Value of Multi-slice spiral CT in diagnosis of malignant gastrointestinal stromal tumors

Objective： The aim of this study was to investigate the value of multi-slice spiral CT （MSCT） in the diagnosis of malignant gastrointestinal stromal tumors （GISTs）. Methods： Twenty-seven cases of MSCT images of malignant GIST proved by surgery and pathology were retrospectively analyzed. Both plain and enhanced CT scan was performed and multiplanar reconstruction was made in all cases. Results： The lesions originated from the stomach （n = 11）, small intestine （n = 9）, colon （n = 4）, rectum （n = 1）, and mesentery （n = 2）. The transverse diameters of mass were 4.2-22 cm, the edges clearly （n = 12）, unclearly （n = 15）. The mass were mainly irregular in shape Iobulated （n = 19）. The lesions were mainly heterogeneity on plain scan, moderate to marked enhancement in arterial phase and durative enhanced in venous phase. Cystic necrosis were observed in all the lesions, 9 cases were cystic and solid mixed mass. Hepatic metastases （n = 4）, pulmonary metastasis （n = 1）, lymphatic metastasis （n = 2） were detected. The accuracy rate of MSCT diagnosis for location and pathologic features of GISTs were 85.2% （23/27） and 77.8% （21/27）. Conclusion： Two-phase MSCT examination and axial images combined with multiplanar reconstruction images have important value for diagnosis of malignant GIST.

Automated lung segmentation algorithm for CAD system of thoracic CT

Objective: To design and test the accuracy and efficiency of our lung segmentation algorithm on thoracic CT image in computer-aided diagnostic (CAD) system, especially on the segmentation between left and right lungs. Methods: We put forward the base frame of our lung segmentation firstly. Then, using optimal thresholding and mathematical morphologic methods, we acquired the rough image of lung segmentation. Finally, we presented a fast self-fit segmentation refinement algorithm, adapting to the unsuccessful left-right lung segmentation of thredsholding. Then our algorithm was used to CT scan images of 30 patients and the results were compared with those made by experts. Results: Experiments on clinical 2-D pulmonary images showed the results of our algorithm were very close to the expert’s manual outlines, and it was very effective for the separation of left and right lungs with a successful segmentation ratio 94.8%. Conclusion: It is a practicable fast lung segmentation algorithm for CAD system on thoracic CT image.

磁共振胆胰管造影联合增强CT诊断良恶性胆道狭窄的价值评价

目的:评价分析磁共振胆胰管造影联合增强CT诊断良恶性胆道狭窄的价值。方法:从我院2017年6月—2018年6月期间收治的胆道狭窄患者中随机抽取60例作为临床研究对象,对患者均采用磁共振胆胰管造影检查和CT增强检查,诊断患者胆道狭窄的良恶性,根据最终的手术病理诊断结果,综合分析磁共振胆胰管造影联合增强CT诊断良恶性胆道狭窄的准确性。参照手术诊断结果,划分患者为良性胆道狭窄组和恶性胆道狭窄组,对比两组患者的CT差值。结果:磁共振胆胰管造影诊断准确率为96.7%,增强CT诊断准确率为95%,准确性较高。良性胆道狭窄组不同性质病变CT差值动脉期为(16.7±7.2)HU、门静脉期为(28.2±9.4)HU、延迟期为(24.7±8.3)HU;恶性胆道狭窄组不同性质病变CT差值动脉期为(29.9±11.9)HU、门静脉期为(51.6±18.5)HU、延迟期为(48.6±16.7)HU,良性组CT差值更高。P <0.05,具备统计学。结论:磁共振胆胰管造影联合增强CT诊断良恶性胆道狭窄更加灵敏和准确,对良恶性胆道狭窄可进行有效区分,临床应用的总体价值较高。

急性阑尾炎中的CT检查价值分析

目的:探讨对急性阑尾炎使用CT诊断的效果分析。方法:回顾性分析在2017年1月—2019年1月时间段,我院收治的疑似急性阑尾炎患者125例,对所有患者进行超声诊断与CT诊断,与后期病理结果比较,分析超声和CT诊断的准确率以及不同类型阑尾炎的诊断率。结果:125例疑似急性阑尾炎患者中,经病理确认有113例为急性阑尾炎,CT诊断出110例,超声诊断出96例,CT诊断准确率明显高于超声诊断(P <0.05),并且CT对单纯阑尾炎、急性化脓性阑尾炎、急性坏疽性阑尾炎、阑尾周围肿胀、肠管扩张的诊断结果与病理结果无统计学差异(P> 0.05)。结论:CT方法诊断急性阑尾炎,诊断准确率较高,对不同类型阑尾炎的诊断准确率与病理结果没有差异,对急性阑尾炎的诊断具有重要意义,可在临床上广泛应用。

A comparative study on CT imaging and pathologic presentation of the periphery of hepatocellular carcinoma using in vivo specimens of liver transplantation

Objective:To examine CT and pathologic presentations of the periphery of hepatocelllar carcinoma (HCC) by using in vivo liver specimens from orthotopic liver transplantation (OLT) and to see whether there is any correlation between them. Materials and Methods:Forty-two patients with HCC confirmed by pathology and liver transplantation were included. Plain CT scan covering the whole liver was done, followed by arterial and portal venous phase scanning. The delay time was 25 s and 60 s after injection of contrast medium. Fresh liver samples were evaluated, sliced and stained with HE and the standard immunoperoxidase method using facterⅧrelated antigen (F8RA) monoclonal antibody to study CT presentation of the periphery of tumor and compare them with pathologic findings. Results: (1) Tumors with clear boundaries on CT scan reflected the presence of tumor capsules in pathologic sections. Most tumors with unclear boundaries had no capsules and grew in an invasive pattern; (2) Tumors with unclear boundaries or high density on dynamic enhancement usually had abundant newborn vessels in the periphery and were poorly differentiated, while those with low density had few newborn vessels and were well differentiated; (3) When microvessel density (MVD) was>30, the occurrence of intrahepatic daughter foci was higher. Conclusion: (1) CT morphologic classification of the HCC periphery can well reflect the intactness of tumor capsules, which is helpful for preoperative assessment of tumor infiltration and cancer cell grading; (2) CT enhancement presentation of the HCC periphery in arterial and portal phases may reflect pathologic changes and help predict the prognosis at large.

Comparative analysis of CT and pathological findings of peripheral nerve sheath tumors

Objective: To improve the qualitative diagnosis of peripheral nerve sheath tumors by computed tomography (CT). Methods: CT findings of 64 cases of pathologically confirmed nerve sheath tumors were compared with the pathological findings of the tumors. Results: Low density of the tumors shown in plain CT images was related to dominating reticular structure in the tumor as found pathologically. Tumors with intact capsule found by pathological findings were shown with smooth margin in CT images. Inhomogeneous density and enhancement of the tumors in CT images was related to tumor necrosis, liquefaction and cystic degeneration, and inhomogeneous enhancement also involved the reticular structure. Conclusion: Nerve sheath tumors are characterized by distribution along the nerves, lower density than that of muscles in plain CT images, and inhomogeneous enhancement in enhanced CT, which can help differentiate nerve sheath tumors from other soft tissue tumors. When nerve sheath tumors lack distinctive CT features, the diagnoses have to depend on their pathological findings.

Helical CT findings and clinicopathologic features in malignant gastrointestinal stromal tumors: the correlation between radiologic appearance and malignant potential

Objective： In this pictorial essay, we described the clinical, pathologic, and computed tomographic （CT） findings of malignant gastrointestinal stromal tumors （MGISTs） and attempt to establish the correlation between radiologic appearance and malignant potential. Methods： This retrospective analysis included 20 patients receiving treatment for MGIST between 2008 and 2010. The diagnosis was established by pathology and immunohistochemistry. All these patients underwent pre- operative CT. Clinical presentation, pathology and CT images were analyzed. Helical CT images were reviewed for morpho- logic features such as tumor size, number and location, tumor margins, necrosis, degree of enhancement and metastasis. Results： Gastrointestinal bleeding, abdominal pain and discomfort, and without clinical symptom were common findings and were observed in 9 （45%）, 6 （30%）, and 5 （25%） of the 20 patients. 8 （40%） tumors were located in stomach, and 10 （50%）, 1 （5%） and 1 （5%） were located in small intestine, mesentery and peritoneum, respectively. Male to female ratio was about 1：2. The size of MGIST ranged from 2.6 cm to 17.5 cm with a mean of 8.7 cm. All tumors density was inhomogeneous and heterogeneous enhancement. MGISTs with highly malignant located in small intestine were about 30% higher than stomach. The ＂satellite＂ turnouts were found in 6 cases with high malignant risk. 7 cases were suffered from liver metastasis, and 4 cases went with seeding into the abdominal cavity, 1 cases went with lymph node metastasis. Histologically, 19 cases （95%） were of spindle cell type. Immunohistochemical stains demonstrated a strong positivity for both c-kit （CDl17） and CD34s enhancement in 19 （95%）. Conclusion： Clinical expression is varied in MGIST patients. Female might be predominance in MGIST. The GISTs located in small intestine would tend to be more aggressive. The satellite tumours, necrosis and cystic degeneration were strongly benefit for MGIST diagnosis. Furthermore, intestinal obstruction doesn＇t support the diagnosis. Lymph node metastasis and calcification is rare.

Multi-phase post-mortem CT-angiography： a pathologic correlation study on cardiovascular sudden death

Multi-phase post-mortem CT-angiography （MPMCTA） has the great potential to increase the quality of the postmortem investigation, especially in the area of sudden death; however, its role as routine complement to the pathology toolbox is still questioned as it needs to be further standardized. The aim of this study is to investigate the contribution of MPMCTA in cases of sudden unexplained death in adults and in particular in sudden cardiovascular death. Sixty-eight sudden unexpected deaths of adults were investigated at our institution between 2012 and 2013. Ten cases underwent MPMCTA and autopsy and were included in the study. Before the angiographic step by complete filling of the vascular system, prior to any manipulation of the body, a non-contrast CT-scan was carried out. Image reconstructions were performed on a CT workstation （Vitrea） and two radiologists experienced with post mortem imaging interpreted the MPMCTA findings. In all 10 cases, we could state a good correlation between combination of post-mortem CT and MPMCTA and autopsy procedures, confirming a high diagnostic sensitivity. With this case series we want to illustrate the advantages offered by performing MPMCTA when facing a sudden death, regardless of specific suspicion for acute coronary syndrome or other vascular or ischemic disease.