51
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An exploratory study toward the contribution of 3D surface scanning for association of an injury with its causing instrument. Int J Legal Med 2018; 133:1167-1176. [PMID: 30506239 DOI: 10.1007/s00414-018-1973-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
Abstract
3D surface scanning is a technique brought forward for wound documentation and analysis in order to identify injury-causing tools in legal medicine and forensic science. Although many case reports have been published, little is known about the methodology employed by the authors. The study reported here is exploratory in nature, and its main purpose was to get a first evaluation of the ability of an operator, by means of 3D surface scanning and following a simple methodology, to correctly exclude or associate an incriminated tool as the source of a mock wound. Based on these results, an assessment of the possibility to define a structured methodology that could be suitable for this use was proposed. Blunt tools were used to produce 'wounds' on watermelons. Both wounds and tools were scanned with a non-contact optical surface 3D digitising system. Analysis of the obtained 3D models of wounds and tools was undertaken separately. This analytical phase was followed by a qualitative and a quantitative comparison. Results showed that in more than half of the cases, we obtained a correct association but the prevalence of wrong association was still high due to mark deformation and other limitations. Even if the findings of this exploratory study cannot be generalised, they suggest that the simple and direct comparison process is not reliable enough for a systematic routine application. The article highlights the importance of an analysis phase preceding the comparison step. Limitations of the technique, ensuring needs and possible paths for improvement are also expounded.
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52
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Diallo-Danebrock R, Abbas M, Groß D, Kellner U. [History of the anatomical and clinical autopsy]. DER PATHOLOGE 2018; 40:93-100. [PMID: 30062578 DOI: 10.1007/s00292-018-0461-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The history of the autopsy is naturally also a part of the history of anatomy and pathology and spans over about 2300 years. The first documented autopsies were conducted in about 300 B.C. Thereafter, due to the prohibition of dissections due to religious, social, or hygienic reasons, a long period of stagnation took place. With the onset of the Renaissance in the 15th and 16th century, interest in the ancient sciences such as anatomy began to rise and consequently an increasing number of dissections for anatomical studies were conducted. Nevertheless, it took nearly 200 years until clinical symptoms and/or causes of disease and death were correlated with anatomical findings. In the second half of the 19th century, the clinical autopsy based on the combination of macroscopic and microscopic findings became more and more important as a precondition for the systematic description of diseases. Based on autopsy findings and together with several new techniques, modern pathology could be established at the beginning of the 20th century as a source of scientific knowledge for the clinical medicine and as a theoretical discipline of its own.
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Affiliation(s)
- R Diallo-Danebrock
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Paul-Ehrlich-Str. 9, 32429, Minden, Deutschland.
| | - M Abbas
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Paul-Ehrlich-Str. 9, 32429, Minden, Deutschland
| | - D Groß
- Institut für Geschichte, Theorie und Ethik der Medizin, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - U Kellner
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Paul-Ehrlich-Str. 9, 32429, Minden, Deutschland
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53
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Bornik A, Urschler M, Schmalstieg D, Bischof H, Krauskopf A, Schwark T, Scheurer E, Yen K. Integrated computer-aided forensic case analysis, presentation, and documentation based on multimodal 3D data. Forensic Sci Int 2018; 287:12-24. [DOI: 10.1016/j.forsciint.2018.03.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 11/24/2022]
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54
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De Marco E, Vacchiano G, Frati P, La Russa R, Santurro A, Scopetti M, Guglielmi G, Fineschi V. Evolution of post-mortem coronary imaging: from selective coronary arteriography to post-mortem CT-angiography and beyond. Radiol Med 2018; 123:351-358. [PMID: 29357039 DOI: 10.1007/s11547-018-0855-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 01/08/2018] [Indexed: 12/17/2022]
Abstract
Since the 1970s, remarkable efforts have been made in the post-mortem coronary study, especially by angiography, as an added tool to diagnose heart-related deaths. In more recent times, post-mortem CT (PMCT) and post-mortem CT-angiography (PMCTA) have become an established practice in numerous forensic units, because of the undeniable advantages these diagnostic instruments can offer: data acquisition times are increasingly fast, costs have become lower and, once acquired, data can be re-utilized and re-evaluated at any given time. This review aims to chart the history of post-mortem cardiac imaging, highlighting its evolution both in terms of methodology and technology as well as the contribution that forensic radiology has been able to offer to forensic pathology, not as an alternative to autopsy but as a guide and aid when performing one. Finally, the latest advances in the study of cardiac deaths are explored, namely by cardiac post-mortem MRI (PMMR), able to visualize all the various stages of a myocardial infarction, post-mortem MRI-angiography (PMMRA), useful in investigating coronary artery pathology and post-mortem cardiac micro-CT, able to provide near-histological levels of myocardial, coronary and valvular detail.
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Affiliation(s)
- Emidio De Marco
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Vacchiano
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
- Malzoni Clinical-Scientific Institute, Avellino, Italy
| | - Raffaele La Russa
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
- Malzoni Clinical-Scientific Institute, Avellino, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Alessandro Santurro
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Matteo Scopetti
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100, Foggia, Italy.
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
- Department of Law, Economics, Management and Quantitative Methods, University of Sannio, Benevento, Italy
- Malzoni Clinical-Scientific Institute, Avellino, Italy
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Post-mortem MR angiography: quantitative investigation and intravascular retention of perfusates in ex situ porcine hearts. Int J Legal Med 2018; 132:579-587. [PMID: 29344721 PMCID: PMC5807516 DOI: 10.1007/s00414-017-1763-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/12/2017] [Indexed: 11/13/2022]
Abstract
As the implementation of minimally invasive imaging techniques in both forensic and pathological practice increases, research in this area focuses on addressing recognised diagnostic weaknesses of current approaches. Assessment of sudden cardiac death (SCD) can be considered one such area in which post-mortem imaging still shows diagnostic weaknesses. We hypothesise that magnetic resonance imaging (MRI) with an angiographic adjunct may improve the visualisation and interpretation of cardiac pathologies in a post-mortem setting. To systematically investigate this hypothesis, selected perfusates (paraffin oil, Gadovist®;-doped physiological solution and polyethylene glycol (PEG)) were injected into the left anterior descending (LAD) artery of ex situ porcine hearts to assess the visualisation of perfusates in MRI as well as their intravascular retention over 12 h. Morphological images were acquired and quantitative T1 maps were generated from inversion recovery data. Visualisation of vascular structure and image quality were assessed using signal-to-noise and contrast-to-noise ratios. Intravascular retention was assessed both visually and statistically using a volume of interest (VOI) approach to analyse significant changes in signal intensity in and around the filled LAD artery, as well as changes in the longitudinal relaxation time (T1) in adjacent myocardium. In addition to presenting possible mechanisms explaining perfusate extravasation given the increased permeability of post-mortem vessels, the potential diagnostic consequences of this phenomenon and the importance of contrast stability and extended intravascular retention are discussed. In light of our findings and these considerations, paraffin oil emerged as the preferred perfusate for use in post-mortem MR angiography.
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56
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Renard Y, Hossu G, Chen B, Krebs M, Labrousse M, Perez M. A guide for effective anatomical vascularization studies: useful ex vivo methods for both CT and MRI imaging before dissection. J Anat 2017; 232:15-25. [PMID: 29023687 DOI: 10.1111/joa.12718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2017] [Indexed: 01/10/2023] Open
Abstract
The objective of this study was to develop a simple and useful injection protocol for imaging cadaveric vascularization and dissection. Mixtures of contrast agent and cast product should provide adequate contrast for two types of ex vivo imaging (MRI and CT) and should harden to allow gross dissection of the injected structures. We tested the most popular contrast agents and cast products, and selected the optimal mixture composition based on their availability and ease of use. All mixtures were first tested in vitro to adjust dilution parameters of each contrast agent and to fine-tune MR imaging acquisition sequences. Mixtures were then injected in 24 pig livers and one human pancreas for MR and computed tomography (CT) imaging before anatomical dissection. Colorized latex, gadobutrol and barite mixture met the above objective. Mixtures composed of copper sulfate (CuSO4 ) gadoxetic acid (for MRI) and iodine (for CT) gave an inhomogeneous signal or extravasation of the contrast agent. Agar did not harden sufficiently for gross dissection but appears useful for CT and magnetic resonance imaging (MRI) studies without dissection. Silicone was very hard to inject but achieved the goals of the study. Resin is particularly difficult to use but could replace latex as an alternative for corrosion instead of dissection. This injection protocol allows CT and MRI images to be obtained of cadaveric vascularization and anatomical casts in the same anatomic specimen. Post-imaging processing software allow easy 3D reconstruction of complex anatomical structures using this technique. Applications are numerous, e.g. surgical training, teaching methods, postmortem anatomic studies, pathologic studies, and forensic diagnoses.
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Affiliation(s)
- Yohann Renard
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Lorraine, Nancy, France.,Department of Anatomy, Faculty of Medicine and University Hospital, University of Reims Champagne-Ardenne, Reims, France.,IADI, INSERM U947, University of Lorraine, Nancy, France
| | - Gabriela Hossu
- IADI, INSERM U947, University of Lorraine, Nancy, France.,INSERM CIT1433, CIC-IT, University Hospital of Nancy, Nancy, France
| | - Bailiang Chen
- IADI, INSERM U947, University of Lorraine, Nancy, France.,INSERM CIT1433, CIC-IT, University Hospital of Nancy, Nancy, France
| | - Marine Krebs
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Lorraine, Nancy, France
| | - Marc Labrousse
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Reims Champagne-Ardenne, Reims, France
| | - Manuela Perez
- Department of Anatomy, Faculty of Medicine and University Hospital, University of Lorraine, Nancy, France.,IADI, INSERM U947, University of Lorraine, Nancy, France
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57
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Wagensveld IM, Blokker BM, Wielopolski PA, Renken NS, Krestin GP, Hunink MG, Oosterhuis JW, Weustink AC. Total-body CT and MR features of postmortem change in in-hospital deaths. PLoS One 2017; 12:e0185115. [PMID: 28953923 PMCID: PMC5617178 DOI: 10.1371/journal.pone.0185115] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/05/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate the frequency of total-body CT and MR features of postmortem change in in-hospital deaths. MATERIALS AND METHODS In this prospective blinded cross-sectional study, in-hospital deceased adult patients underwent total-body postmortem CT and MR followed by image-guided biopsies. The presence of PMCT and PMMR features related to postmortem change was scored retrospectively and correlated with postmortem time interval, post-resuscitation status and intensive care unit (ICU) admittance. RESULTS Intravascular air, pleural effusion, periportal edema, and distended intestines occurred more frequently in patients who were resuscitated compared to those who were not. Postmortem clotting was seen less often in resuscitated patients (p = 0.002). Distended intestines and loss of grey-white matter differentiation in the brain showed a significant correlation with postmortem time interval (p = 0.001, p<0.001). Hyperdense cerebral vessels, intravenous clotting, subcutaneous edema, fluid in the abdomen and internal livores of the liver were seen more in ICU patients. Longer postmortem time interval led to a significant increase in decomposition related changes (p = 0.026). CONCLUSIONS There is a wide variety of imaging features of postmortem change in in-hospital deaths. These imaging features vary among clinical conditions, increase with longer postmortem time interval and must be distinguished from pathologic changes.
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Affiliation(s)
- Ivo M. Wagensveld
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
- Department of Pathology, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
- * E-mail:
| | - Britt M. Blokker
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
- Department of Pathology, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
| | - Piotr A. Wielopolski
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
| | - Nomdo S. Renken
- Department of Radiology, Reinier de Graaf Gasthuis, Delft, Zuid-Holland, The Netherlands
| | - Gabriel P. Krestin
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
| | - Myriam G. Hunink
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
- Centre for Health Decision Science, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
| | - J. Wolter Oosterhuis
- Department of Pathology, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
| | - Annick C. Weustink
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
- Department of Pathology, Erasmus University Medical Centre, Rotterdam, Zuid-Holland, The Netherlands
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58
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Basso C, Aguilera B, Banner J, Cohle S, d'Amati G, de Gouveia RH, di Gioia C, Fabre A, Gallagher PJ, Leone O, Lucena J, Mitrofanova L, Molina P, Parsons S, Rizzo S, Sheppard MN, Mier MPS, Kim Suvarna S, Thiene G, van der Wal A, Vink A, Michaud K. Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology. Virchows Arch 2017; 471:691-705. [PMID: 28889247 PMCID: PMC5711979 DOI: 10.1007/s00428-017-2221-0] [Citation(s) in RCA: 306] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 02/07/2023]
Abstract
Although sudden cardiac death (SCD) is one of the most important modes of death in Western countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate diagnosis of the causes of SCD is now of particular importance. Pathologists are responsible for determining the precise cause and mechanism of sudden death but there is still considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology has developed these guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate investigation of SCD. The present version is an update of our original article, published 10 years ago. This is necessary because of our increased understanding of the genetics of cardiovascular diseases, the availability of new diagnostic methods, and the experience we have gained from the routine use of the original guidelines. The updated guidelines include a detailed protocol for the examination of the heart and recommendations for the selection of histological blocks and appropriate material for toxicology, microbiology, biochemistry, and molecular investigation. Our recommendations apply to university medical centers, regionals hospitals, and all healthcare professionals practicing pathology and forensic medicine. We believe that their adoption throughout Europe will improve the standards of autopsy practice, allow meaningful comparisons between different communities and regions, and permit the identification of emerging patterns of diseases causing SCD. Finally, we recommend the development of regional multidisciplinary networks of cardiologists, geneticists, and pathologists. Their role will be to facilitate the identification of index cases with a genetic basis, to screen appropriate family members, and ensure that appropriate preventive strategies are implemented.
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Affiliation(s)
- Cristina Basso
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
| | - Beatriz Aguilera
- Histopathology Service, National Institute of Toxicology and Forensic Sciences, Madrid, Spain
| | - Jytte Banner
- Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Cohle
- Department of Pathology and Laboratory Medicine, Grand Rapids, MI, USA
| | - Giulia d'Amati
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Rosa Henriques de Gouveia
- Department of Pathology, Hospital de Santa Cruz (CHLO), Lisbon & Forensic Pathology, INMLCF & FMUC, Coimbra, Portugal
| | - Cira di Gioia
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Rome, Italy
| | - Aurelie Fabre
- Department of Histopathology, St Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | | | - Ornella Leone
- Department of Pathology, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | - Joaquin Lucena
- Forensic Pathology Service, Institute of Legal Medicine and Forensic Sciences, Seville, Spain
| | - Lubov Mitrofanova
- Department of Pathology, Federal Almazov North-West Medical Research Centre, St. Petersburg, Russian Federation
| | - Pilar Molina
- Forensic Pathology Service, Institute of Legal Medicine and Forensic Sciences, Valencia, Spain
| | - Sarah Parsons
- Victorian Institute of Forensic Medicine and Monash University, Victoria, Australia
| | - Stefania Rizzo
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Mary N Sheppard
- Department of Cardiovascular Pathology, St Georges Medical School, London, UK
| | - Maria Paz Suárez Mier
- Histopathology Service, National Institute of Toxicology and Forensic Sciences, Madrid, Spain
| | | | - Gaetano Thiene
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Allard van der Wal
- Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Aryan Vink
- Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Katarzyna Michaud
- University Hospital of Lausanne, University Center of Legal Medicine, Lausanne and Geneva, Chemin de la Vulliette 4, 25, 1000, Lausanne, Switzerland.
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59
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Henes FO, Regier M, Bannas P, Henker M, Heinemann A, Sperhake J, Begemann PGC, Adam G, Groth M. Early time-related course of image findings in postmortem MRI: Typical findings and observer agreement in a porcine model. Leg Med (Tokyo) 2017; 28:15-21. [PMID: 28738216 DOI: 10.1016/j.legalmed.2017.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/23/2017] [Accepted: 07/14/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess early time-related image findings in postmortem magnetic resonance imaging (MRI) and to evaluate observer agreement in a porcine model. MATERIAL AND METHODS Three pigs were examined by MRI at 15 different time points in the first 36h after death. Two observers independently recorded the postmortem interval (PMI) to the appearance of fluid collection (pleural space, interlobar and interlobular pulmonary fissures and hepatic interlobar fissures), gas accumulation (intrahepatic and intracardial) and blood clotting (aorta and intrahepatic venous vessels). Cohen's Kappa statistics and intraclass correlation coefficient (ICC) were used to evaluate intra- and interobserver agreement. RESULTS Intrahepatic gas was evident after 12, 17 and 30h. Also, intracardiac gas was present in all animals. However, no chronological appearance has been observed. Blood clotting in the hepatic vein was observed within 3min, aortic clotting with a delay of 2-12h after death. Interlobular pulmonary fluid (median PMI: 2h, range 2-2h), pleural effusion (median PMI: 10.5h, range 9-12h) and hepatic interlobar fissure fluid (median PMI: 11.5h, range 11-12h) displayed a chronological appearance pattern. Qualitative and quantitative detection of most postmortem findings showed excellent intra- and interobserver agreement with Kappa values>0.8 or ICC>0.75. CONCLUSION Pulmonary and hepatic fissural fluid collection as well as intravasal gas accumulation are early time-related image findings in postmortem MRI. The chronological appearance of these findings can be assessed with excellent observer agreement in a porcine model.
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Affiliation(s)
- Frank Oliver Henes
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Marc Regier
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Peter Bannas
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Marlen Henker
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Axel Heinemann
- Department of Legal Medicine University Medical Center Hamburg-Eppendorf, Butenfeld 34, Hamburg 22529, Germany
| | - Jan Sperhake
- Department of Legal Medicine University Medical Center Hamburg-Eppendorf, Butenfeld 34, Hamburg 22529, Germany
| | - Philipp G C Begemann
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Gerhard Adam
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Michael Groth
- Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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60
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Temperature-corrected post-mortem 1.5 T MRI quantification of non-pathologic upper abdominal organs. Int J Legal Med 2017. [DOI: 10.1007/s00414-017-1622-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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61
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Fahrni S, Campana L, Dominguez A, Uldin T, Dedouit F, Delémont O, Grabherr S. CT-scan vs. 3D surface scanning of a skull: first considerations regarding reproducibility issues. Forensic Sci Res 2017; 2:93-99. [PMID: 30483625 PMCID: PMC6197135 DOI: 10.1080/20961790.2017.1334353] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/22/2017] [Indexed: 11/03/2022] Open
Abstract
Three-dimensional surface scanning (3DSS) and multi-detector computed tomography (MDCT) are two techniques that are used in legal medicine for digitalizing objects, a body or body parts such as bones. While these techniques are more and more commonly employed, surprisingly little information is known about the quality rendering of digitalized three-dimensional (3D) models provided by each of them. This paper presents findings related to the measurement precision of 3D models obtained through observation of a study case, where a fractured skull reconstructed by an anthropologist was digitalized using both post-mortem imaging methods. Computed tomography (CT) scans were performed using an 8-row MDCT unit with two different slice thicknesses. The variability of 3D CT models superimposition allowed to assess the reproducibility and robustness of this digitalization technique. Furthermore, two 3D surface scans were done using a professional high resolution 3D digitizer. The comparison of 3D CT-scans with 3D surface scans by superimposition demonstrated several regions with significant differences in topology (average difference between +1.45 and -1.22 mm). When comparing the reproducibility between these two digitalizing techniques, it appeared that MDCT 3D models led in general to greater variability for measurement precision between scanned surfaces. Also, the reproducibility was better achieved with the 3D surface digitizer, showing 3D models with fewer and less pronounced differences (from +0.32 to -0.31 mm). These experiments suggest that MDCT provides less reproducible body models than 3D surface scanning. But further studies must be undertaken in order to corroborate this first impression, and possibly explain the reason for these findings.
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Affiliation(s)
- Stella Fahrni
- School of Criminal Justice, University of Lausanne, Lausanne-Dorigny, Switzerland.,Department of Forensic Imaging, University Centre for Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Lorenzo Campana
- Department of Forensic Imaging, University Centre for Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Alejandro Dominguez
- Department of Technological Radiology, Health School of Sciences Vaud - HESAV, Lausanne, Switzerland
| | - Tanya Uldin
- Department of Forensic Imaging, University Centre for Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Fabrice Dedouit
- Department of Forensic Imaging, University Centre for Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Olivier Delémont
- School of Criminal Justice, University of Lausanne, Lausanne-Dorigny, Switzerland
| | - Silke Grabherr
- Department of Forensic Imaging, University Centre for Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
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62
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Grabherr S, Egger C, Vilarino R, Campana L, Jotterand M, Dedouit F. Modern post-mortem imaging: an update on recent developments. Forensic Sci Res 2017; 2:52-64. [PMID: 30483621 PMCID: PMC6197109 DOI: 10.1080/20961790.2017.1330738] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/05/2017] [Indexed: 12/25/2022] Open
Abstract
Modern post-mortem investigations use an increasing number of digital imaging methods, which can be collected under the term "post-mortem imaging". Most methods of forensic imaging are from the radiology field and are therefore techniques that show the interior of the body with technologies such as X-ray or magnetic resonance imaging. To digitally image the surface of the body, other techniques are regularly applied, e.g. three-dimensional (3D) surface scanning (3DSS) or photogrammetry. Today's most frequently used techniques include post-mortem computed tomography (PMCT), post-mortem magnetic resonance imaging (PMMR), post-mortem computed tomographic angiography (PMCTA) and 3DSS or photogrammetry. Each of these methods has specific advantages and limitations. Therefore, the indications for using each method are different. While PMCT gives a rapid overview of the interior of the body and depicts the skeletal system and radiopaque foreign bodies, PMMR allows investigation of soft tissues and parenchymal organs. PMCTA is the method of choice for viewing the vascular system and detecting sources of bleeding. However, none of those radiological methods allow a detailed digital view of the body's surface, which makes 3DSS the best choice for such a purpose. If 3D surface scanners are not available, photogrammetry is an alternative. This review article gives an overview of different imaging techniques and explains their applications, advantages and limitations. We hope it will improve understanding of the methods.
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Affiliation(s)
- Silke Grabherr
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Coraline Egger
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Raquel Vilarino
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
- Service of Legal Medicine, Central Institute of Hospitals, Sion, Switzerland
| | - Lorenzo Campana
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Melissa Jotterand
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
| | - Fabrice Dedouit
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne, Switzerland
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Watson E, Heng HG. FORENSIC RADIOLOGY AND IMAGING FOR VETERINARY RADIOLOGISTS. Vet Radiol Ultrasound 2017; 58:245-258. [PMID: 28233422 DOI: 10.1111/vru.12484] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 12/12/2022] Open
Abstract
Imaging studies are often of evidentiary value in medicolegal investigations involving animals and the role of the veterinary radiologist is to interpret those images for courts as an expert or opinion witness. With progressing interest in prosecuting animal crimes and strengthening of penalties for crimes against animals, the participation of veterinary radiologists in medicolegal investigations is expected to increase. Veterinary radiologists who are aware of radiographic and imaging signs that result in animal suffering, abuse, or neglect; knowledgeable in ways radiology and imaging may support cause of death determinations; conversant in postmortem imaging; comfortable discussing mechanisms and timing of blunt or sharp force and projectile trauma in imaging; and prepared to identify mimics of abuse can assist court participants in understanding imaging evidence. The goal of this commentary review is to familiarize veterinary radiologists with the forensic radiology and imaging literature and with the advantages and disadvantages of various imaging modalities utilized in forensic investigations. Another goal is to provide background information for future research studies in veterinary forensic radiology and imaging.
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Affiliation(s)
- Elizabeth Watson
- Department of Pathology, Immunology, and Laboratory Medicine, Veterinary Forensic Sciences, University of Florida College of Medicine, Gainesville, FL, 32610
| | - Hock Gan Heng
- Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison Street, West Lafayette, IN, 47907
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Kottner S, Ebert LC, Ampanozi G, Braun M, Thali MJ, Gascho D. VirtoScan - a mobile, low-cost photogrammetry setup for fast post-mortem 3D full-body documentations in x-ray computed tomography and autopsy suites. Forensic Sci Med Pathol 2017; 13:34-43. [DOI: 10.1007/s12024-016-9837-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 11/24/2022]
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65
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Noriki S, Kinoshita K, Inai K, Sakai T, Kimura H, Yamauchi T, Iwano M, Naiki H. Newly recognized cerebral infarctions on postmortem imaging: a report of three cases with systemic infectious disease. BMC Med Imaging 2017; 17:4. [PMID: 28068928 PMCID: PMC5223344 DOI: 10.1186/s12880-016-0174-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 12/22/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Postmortem imaging (PMI) refers to the imaging of cadavers by computed tomography (CT) and/or magnetic resonance imaging (MRI). Three cases of cerebral infarctions that were not found during life but were newly recognized on PMI and were associated with severe systemic infections are presented. CASE PRESENTATIONS An 81-year-old woman with a pacemaker and slightly impaired liver function presented with fever. Imaging suggested interstitial pneumonia and an iliopsoas abscess, and blood tests showed liver dysfunction and disseminated intravascular coagulation (DIC). Despite three-agent combined therapy for tuberculosis, she died 32 days after hospitalization. PMI showed multiple fresh cerebral and cerebellar infarctions and diffuse ground-glass shadows in bilateral lungs. On autopsy, the diagnosis of miliary tuberculosis was made, and non-bacterial thrombotic endocarditis that involved the aortic valve may have caused the cerebral infarctions. A 74-year-old man on steroid therapy for systemic lupus erythematosus presented with severe anemia, melena with no obvious source, and DIC. Imaging suggested intestinal perforation. The patient was treated with antibiotics and drainage of ascites. However, he developed adult respiratory distress syndrome, worsening DIC, and renal dysfunction and died 2 months after admission. PMI showed infiltrative lung shadow, ascites, an abdominal aortic aneurysm, a wide infarction in the right parietal lobe, and multiple new cerebral infarctions. Autopsy examination showed purulent ascites, diffuse peritonitis, invasive bronchopulmonary aspergillosis, and non-bacterial thrombotic endocarditis that likely caused the cerebral infarctions. A 65-year-old man with an old pontine infarction presented with a fever and neutropenia. Despite appropriate treatment, his fever persisted. CT showed bilateral upper lobe pneumonia, pain appeared in both femoral regions, and intramuscular abscesses of both shoulders developed. His pneumonia worsened, his level of consciousness decreased, right hemiplegia developed, and he died. PMI showed a newly diagnosed cerebral infarction in the left parietal lobe. The autopsy revealed bilateral bronchopneumonia, right-sided pleuritis with effusion, an intramuscular abscess in the right thigh, and fresh multiple organ infarctions. Systemic fibrin thrombosis and DIC were also found. Postmortem cultures showed E. coli and Burkholderia cepacia. CONCLUSION Cerebral infarction that is newly recognized on PMI might suggest the presence of severe systemic infection.
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Affiliation(s)
- Sakon Noriki
- Division of Tumor Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, 910-1193, Fukui, Japan. .,Autopsy Imaging Center, School of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Kazuyuki Kinoshita
- Division of Radiology, Department of Radiology and Laboratory Medicine, School of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, 910-1193, Fukui, Japan.,Autopsy Imaging Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kunihiro Inai
- Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, Fukui, Japan.,Autopsy Imaging Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Toyohiko Sakai
- Division of Radiology, Department of Radiology and Laboratory Medicine, School of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, 910-1193, Fukui, Japan.,Autopsy Imaging Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirohiko Kimura
- Division of Radiology, Department of Radiology and Laboratory Medicine, School of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, 910-1193, Fukui, Japan.,Autopsy Imaging Center, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Division of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, 910-1193, Fukui, Japan
| | - Masayuki Iwano
- Division of Nephrology, Department of General Medicine, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, 910-1193, Fukui, Japan
| | - Hironobu Naiki
- Division of Molecular Pathology, Department of Pathological Sciences, School of Medical Sciences, University of Fukui, Fukui, Japan.,Autopsy Imaging Center, School of Medical Sciences, University of Fukui, Fukui, Japan
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Okuma H, Gonoi W, Ishida M, Shirota G, Kanno S, Shintani Y, Abe H, Fukayama M, Ohtomo K. Comparison of the cardiothoracic ratio between postmortem and antemortem computed tomography. Leg Med (Tokyo) 2016; 24:86-91. [PMID: 28081797 DOI: 10.1016/j.legalmed.2016.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 12/17/2016] [Accepted: 12/19/2016] [Indexed: 10/20/2022]
Abstract
As postmortem imaging has gained prominence as a supplement to traditional autopsy, it is important to understand the normal postmortem changes to enable the accurate evaluation of postmortem imaging. No studies have evaluated the postmortem changes in cardiothoracic ratio (CTR) compared with antemortem images in the same subjects. We studied 147 consecutive subjects who underwent antemortem and postmortem CT, and autopsy. Postmortem CT was performed <23h after death and was followed by autopsy. The subjects were divided into three groups: normal heart, old myocardial infarction, and CPR-treated hearts. CTR was compared between antemortem and postmortem CT using paired t tests, which revealed that the CTR was greater on postmortem CT than on antemortem CT in all groups (mean CTR: 0.53±0.06vs. 0.50±0.06, respectively; P<0.01). Sex, age, time elapsed since death, and the causes of death were examined as potential confounding factors for the postmortem changes in CTR, but no significant associations were found. Receiver-operating characteristic (ROC) curves were used to determine CTR values for cardiomegaly, which was defined according to the autopsy weight of the heart. The area under the ROC curve was 0.71 (95% confidence interval 0.63-0.79). The CTR threshold of 0.54 identified cardiomegaly with the greatest accuracy, compared with the general threshold of 0.50. In conclusion, the CT-determined CTR increases after death, irrespective of the heart's condition. We should be cautious of overdiagnosis of cardiomegaly on postmortem CT, and new criteria for interpreting cardiomegaly on postmortem CTR are needed.
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Affiliation(s)
- Hidemi Okuma
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Masanori Ishida
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, 2-5 Kandasurugadai, Chiyoda-ku, Tokyo 101-8326, Japan
| | - Go Shirota
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shigeaki Kanno
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yukako Shintani
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kuni Ohtomo
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Webb B, Widek T, Neumayer B, Bruguier C, Scheicher S, Sprenger H, Grabherr S, Schwark T, Stollberger R. Temperature dependence of viscosity, relaxation times (T 1, T 2) and simulated contrast for potential perfusates in post-mortem MR angiography (PMMRA). Int J Legal Med 2016; 131:739-749. [PMID: 27900508 PMCID: PMC5388705 DOI: 10.1007/s00414-016-1482-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/10/2016] [Indexed: 11/27/2022]
Abstract
Developments in post-mortem imaging increasingly focus on addressing recognised diagnostic weaknesses, especially with regard to suspected natural deaths. Post-mortem MR angiography (PMMRA) may offer additional diagnostic information to help address such weaknesses, specifically in the context of sudden cardiac death. Complete filling of the coronary arteries and acceptable contrast with surrounding tissue are essential for a successful approach to PMMRA. In this work, the suitability of different liquids for inclusion in a targeted PMMRA protocol was evaluated. Factors influencing cooling of paraffinum liquidum + Angiofil® (6 %) in cadavers during routine multiphase post-mortem CT angiography were investigated. The temperature dependence of dynamic viscosity (8–20 °C), longitudinal (T1) and transverse (T2) relaxation (1–23 °C) of the proposed liquids was quadratically modelled. The relaxation behaviour of these liquids and MR scan parameters were further investigated by simulation of a radiofrequency (RF)-spoiled gradient echo (GRE) sequence to estimate potentially achievable contrast between liquids and post-mortem tissue at different temperatures across a forensically relevant temperature range. Analysis of the established models and simulations indicated that based on dynamic viscosity (27–33 mPa · s), short T1 relaxation times (155–207 ms) and a minimal temperature dependence over the investigated range of these parameters, paraffin oil and a solution of paraffin oil + Angiofil® (6 %) would be most suitable for post-mortem reperfusion and examination in MRI.
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Affiliation(s)
- Bridgette Webb
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/2., Graz, 8010, Austria.
- Institute of Forensic Medicine, Medical University Graz, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
| | - Thomas Widek
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/2., Graz, 8010, Austria
- BioTechMed-Graz, Graz, Austria
| | - Bernhard Neumayer
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/2., Graz, 8010, Austria
- BioTechMed-Graz, Graz, Austria
| | - Christine Bruguier
- University Center of Legal Medicine, Lausanne-Geneva, University of Lausanne, Lausanne, Switzerland
| | - Sylvia Scheicher
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/2., Graz, 8010, Austria
- BioTechMed-Graz, Graz, Austria
| | - Hanna Sprenger
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/2., Graz, 8010, Austria
- BioTechMed-Graz, Graz, Austria
| | - Silke Grabherr
- University Center of Legal Medicine, Lausanne-Geneva, University of Lausanne, Lausanne, Switzerland
| | - Thorsten Schwark
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Universitätsplatz 4/2., Graz, 8010, Austria
- Institute of Forensic Medicine, Medical University Graz, Graz, Austria
| | - Rudolf Stollberger
- BioTechMed-Graz, Graz, Austria
- Institute of Medical Engineering, Graz University of Technology, Graz, Austria
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Mokrane FZ, Colleter R, Duchesne S, Gerard P, Savall F, Crubezy E, Guilbeau-Frugier C, Moreno R, Sewonu A, Rousseau H, Telmon N, Dedouit F. Old hearts for modern investigations: CT and MR for archaeological human hearts remains. Forensic Sci Int 2016; 268:14-24. [PMID: 27665272 DOI: 10.1016/j.forsciint.2016.08.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 07/20/2016] [Accepted: 08/29/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Among 800 burials dated between the 15th and 18th centuries and found in the center of Rennes (Brittany, France), a collection of five heart-shaped lead urns was discovered. This material was studied using classical methods (external study, autopsy and histology), and also modern imaging like computed tomography (CT), magnetic resonance (MR) before and after coronary opacification. The aim of this manuscript is to describe different steps of ancient soft tissues study, especially using imaging techniques. METHODS The study gathered various specialists: anthropologists, archeologists, forensic pathologists, radiologists, pathologic physicians, and physicists. Imaging techniques were performed, before and after coronary opacification. Finally, hearts were autopsied and different histological samples were analyzed. RESULTS Only heart n°2 was too damaged to be studied. Heart n°3 was considered as normal using all investigation techniques. The study of Hearts n°s 4 and 5 revealed dilated cardiomyopathy while Heart n°1 showed important signs of diffuse hypertrophic cardiomyopathy. Different fibro lipid plaques were identified using imaging techniques, and were confirmed by histology. CONCLUSIONS The study of archeological soft tissues using modern imaging is possible if the material is well-preserved. This type of research can uncover principal findings, allowing scientists to establish diseases of ancient times.
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Affiliation(s)
- F Z Mokrane
- Service de radiologie Rangueil Toulouse, 1 Avenue du Professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France; Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France.
| | - R Colleter
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France; INRAP 37 rue du Bignon, CS67737, 35577 Cesson-Sévigné Cedex, France
| | - S Duchesne
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France; INRAP 37 rue du Bignon, CS67737, 35577 Cesson-Sévigné Cedex, France
| | - P Gerard
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France
| | - F Savall
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France; Service de médecine légale Rangueil Toulouse 1 Avenue du professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France
| | - E Crubezy
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France
| | - C Guilbeau-Frugier
- Service d'anatomie pathologique Rangueil Toulouse, 1 Avenue du Professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France
| | - R Moreno
- Service de radiologie Rangueil Toulouse, 1 Avenue du Professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France; INSERM U1048 - Institut des Maladies Moléculaires et Cardiovasculaires (I2MC, INSERM U1048), CHU Rangueil, 1 Avenue Jean Poulhes - Bâtiment L3-BP 84225 31432 Toulouse Cedex 4, France
| | - A Sewonu
- Service de radiologie Rangueil Toulouse, 1 Avenue du Professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France; INSERM U1048 - Institut des Maladies Moléculaires et Cardiovasculaires (I2MC, INSERM U1048), CHU Rangueil, 1 Avenue Jean Poulhes - Bâtiment L3-BP 84225 31432 Toulouse Cedex 4, France
| | - H Rousseau
- Service de radiologie Rangueil Toulouse, 1 Avenue du Professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France; INSERM U1048 - Institut des Maladies Moléculaires et Cardiovasculaires (I2MC, INSERM U1048), CHU Rangueil, 1 Avenue Jean Poulhes - Bâtiment L3-BP 84225 31432 Toulouse Cedex 4, France
| | - N Telmon
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France; Service de médecine légale Rangueil Toulouse 1 Avenue du professeur Jean Poulhès, TSA 30052, 31059 Toulouse Cedex 9, France
| | - F Dedouit
- Laboratoire A.M.I.S (Anthropobiologie Moléculaire et Imagerie de Synthèse) UMR5288 - Faculté de Médecine Purpan, 37 Allées Jules Guesde 31073, Toulouse Cedex 7, France; Centre universitaire romand de médecine légale, Chemin de la Vulliette 4, CH-1000 Lausanne 25, Switzerland
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Papilledema as a Diagnostic Sign of Cerebral Edema on Postmortem Magnetic Resonance Imaging. Am J Forensic Med Pathol 2016; 37:264-269. [PMID: 27571174 DOI: 10.1097/paf.0000000000000265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to investigate papilledema (PA) as a diagnostic criterion for the presence of antemortem or agonal cerebral edema despite normal postmortem brain swelling on postmortem magnetic resonance imaging (PMMR) in comparison with conventional autopsy.One hundred subjects with head PMMR and autopsy were included in this study. The sensitivities, spec icities, positive predictive values (PPVs), negative predictive values (NPVs), and accuracies were calculated in terms of the PA, PMMR, and cerebral edema on autopsy. Spearman r tests were used to analyze the linear correlations of PA and the radiological and autoptic determination of cerebral edema.In autopsy, the sensitivity regarding the presence of PA and cerebral edema was 66.2% (PPV, 70.5%), and specificity was 48.6% (NPV, 28.3%), with an overall accuracy of 60%. On PMMR, the sensitivity was 86.6% (PPV, 95%). The specificity was 90.9% (NPV, 34%), with an overall accuracy of 88%. The Spearman correlation revealed a statistically significant result (P < 0.001), which indicated a strong linear correlation of the presence of PA and cerebral edema with the autopsy results and the PMMR results.The presence of PA may aid in the diagnoses of cerebral edema despite normal postmortem brain swelling based on PMMR.
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Forensic 3D surface documentation at the Institute of Forensic Medicine in Zurich – Workflow and communication pipeline. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jofri.2015.11.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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71
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A moot point! A homicide case report on ambiguous projectile movement on postmortem MR. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jofri.2015.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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72
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Post-mortem CT and MR brain imaging of putrefied corpses. Int J Legal Med 2016; 130:1061-1068. [DOI: 10.1007/s00414-016-1385-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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73
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Abstract
A thorough understanding of the physical and chemical changes that occur in the body after death is critical for accurate interpretation of gross and microscopic pathology at autopsy. Furthermore, knowledge of the postmortem processes and the factors that affect them will aid in the estimation of the postmortem interval (PMI). The estimation of the PMI is important in many human and animal death investigations. Despite many decades of research, accuracy in estimation of the time of death has not significantly improved, and no single method can be reliably used to accurately estimate the time of death. Great care should be taken when formulating such an estimate, for it is dependent on multiple circumstantial and environmental factors, and the accuracy and precision of the estimate decrease as the PMI increases. The majority of the research in the field has been conducted on human bodies, but many relevant conclusions may be drawn regarding the expected postmortem changes in animals and the estimation of the PMI. The veterinary pathologist must use great caution when attempting to extrapolate data and apply formulas designed for use in humans. Methods reviewed include gross changes, microscopic changes, temperature-based methods, postmortem chemistry, molecular methods, microbial assay, ocular changes, radiography, entomology, and others. Although only several of these methods are currently practical for use in the workup of cases, it is expected that future research will result in improved techniques with enhanced accuracy in the estimation of the PMI, which will benefit both human and veterinary forensic investigations.
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Affiliation(s)
- J W Brooks
- Animal Diagnostic Laboratory, Department of Veterinary and Biomedical Sciences, College of Agricultural Sciences, The Pennsylvania State University, University Park, PA
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74
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Adolphi NL. An equation-free introduction to post-mortem MR image contrast and pulse sequence optimization. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.jofri.2015.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zech WD, Hottinger AL, Schwendener N, Schuster F, Persson A, Warntjes MJ, Jackowski C. Post-mortem 1.5T MR quantification of regular anatomical brain structures. Int J Legal Med 2016; 130:1071-1080. [DOI: 10.1007/s00414-016-1318-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/13/2016] [Indexed: 10/22/2022]
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Shiotani S, Kobayashi T, Hayakawa H, Homma K, Sakahara H. Hepatic Relaxation Times from Postmortem MR Imaging of Adult Humans. Magn Reson Med Sci 2015; 15:281-7. [PMID: 26701693 PMCID: PMC5608124 DOI: 10.2463/mrms.mp.2015-0086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose: To measure T1 and T2 values of hepatic postmortem magnetic resonance (PMMR) imaging. Materials and Methods: We performed hepatic PMMR imaging of 22 deceased adults (16 men, 6 women; mean age, 56.3 years) whose deaths were for reasons other than liver injury or disease at a mean of 27.7 hours after death. Before imaging, the bodies were kept in cold storage at 4°C (mean rectal temperature, 17.6°C). We measured T1 and T2 values in the liver at two sites (the anterior segment of the right lobe and the lateral segment of the left lobe). We also investigated the influence of the body temperature and postmortem interval on T1 and T2 values. Results: In the anterior segment of the right lobe and the lateral segment of the left lobe, T1 values of PMMR imaging were 524 ± 112 ms and 472 ± 104 ms (mean ± standard deviation), respectively; while T2 values were 42 ± 6 ms and 43 ± 8 ms, respectively. T1 and T2 values did not differ significantly between the two sites (P ≧ 0.05). Regarding temperature, the T2 values of hepatic PMMR imaging were linearly correlated with the body temperature, but the T1 values were not. The T1 and T2 values of the two sites in the liver did not correlate with the postmortem interval. Conclusion: Reduction in body temperature after death is considered to induce T1 and T2 value changes in the liver on PMMR imaging.
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Ampanozi G, Hatch GM, Flach PM, Thali MJ, Ruder TD. Postmortem magnetic resonance imaging: Reproducing typical autopsy heart measurements. Leg Med (Tokyo) 2015; 17:493-8. [DOI: 10.1016/j.legalmed.2015.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 10/21/2015] [Accepted: 10/22/2015] [Indexed: 11/29/2022]
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78
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Deep Into the Fibers! Postmortem Diffusion Tensor Imaging in Forensic Radiology. Am J Forensic Med Pathol 2015; 36:153-61. [DOI: 10.1097/paf.0000000000000177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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79
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Grabherr S, Baumann P, Fahrni S, Mangin P, Grimm J. Virtuelle vs. reale forensische bildgebende Verfahren. Rechtsmedizin (Berl) 2015. [DOI: 10.1007/s00194-015-0047-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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80
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Application of contrast media in post-mortem imaging (CT and MRI). Radiol Med 2015; 120:824-34. [PMID: 25841652 DOI: 10.1007/s11547-015-0532-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/12/2015] [Indexed: 01/17/2023]
Abstract
The application of contrast media in post-mortem radiology differs from clinical approaches in living patients. Post-mortem changes in the vascular system and the absence of blood flow lead to specific problems that have to be considered for the performance of post-mortem angiography. In addition, interpreting the images is challenging due to technique-related and post-mortem artefacts that have to be known and that are specific for each applied technique. Although the idea of injecting contrast media is old, classic methods are not simply transferable to modern radiological techniques in forensic medicine, as they are mostly dedicated to single-organ studies or applicable only shortly after death. With the introduction of modern imaging techniques, such as post-mortem computed tomography (PMCT) and post-mortem magnetic resonance (PMMR), to forensic death investigations, intensive research started to explore their advantages and limitations compared to conventional autopsy. PMCT has already become a routine investigation in several centres, and different techniques have been developed to better visualise the vascular system and organ parenchyma in PMCT. In contrast, the use of PMMR is still limited due to practical issues, and research is now starting in the field of PMMR angiography. This article gives an overview of the problems in post-mortem contrast media application, the various classic and modern techniques, and the issues to consider by using different media.
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81
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Abe K, Kobayashi T, Shiotani S, Saito H, Kaga K, Tashiro K, Someya S, Hayakawa H, Homma K. Optimization of Inversion Time for Postmortem Fluid-attenuated Inversion Recovery (FLAIR) MR Imaging at 1.5T: Temperature-based Suppression of Cerebrospinal Fluid. Magn Reson Med Sci 2015; 14:251-5. [PMID: 25833274 DOI: 10.2463/mrms.2014-0086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Signal intensity (SI) and image contrast on postmortem magnetic resonance (MR) imaging are different from those of imaging of living bodies. We sought to suppress the SI of cerebrospinal fluid (CSF) sufficiently for fluid-attenuated inversion recovery (FLAIR) sequence in postmortem MR (PMMR) imaging by optimizing inversion time (TI). MATERIALS AND METHODS We subject 28 deceased patients to PMMR imaging 3 to 113 hours after confirmation of death (mean, 27.4 hrs.). PMMR imaging was performed at 1.5 tesla, and T1 values of CSF were measured with maps of relaxation time. Rectal temperatures (RT) measured immediately after PMMR imaging ranged from 6 to 32°C (mean, 15.4°C). We analyzed the relationship between T1 and RT statistically using Pearson's correlation coefficient. We obtained FLAIR images from one cadaver using both a TI routinely used for living bodies and an optimized TI calculated from the RT. RESULTS T1 values of CSF ranged from 2159 to 4063 ms (mean 2962.4), and there was a significantly positive correlation between T1 and RT (r = 0.96, P < 0.0001). The regression expression for the relationship was T1 = 74.4 * RT + 1813 for a magnetic field strength of 1.5T. The SI of CSF was effectively suppressed with the optimized TI (0.693 * T1), namely, TI = 0.693 * (77.4 * RT + 1813). CONCLUSION Use of the TI calculated from the linear regression of the T1 and RT optimizes the FLAIR sequence of PMMR imaging.
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Affiliation(s)
- Kazuyuki Abe
- Department of Radiological Science, Faculty of Health Sciences, Junshin Gakuen University
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82
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Mueller S, Thali Y, Ampanozi G, Flach P, Thali M, Hatch G, Ruder T. Distended diameter of the inferior vena cava is suggestive of pulmonary thromboembolism on unenhanced post-mortem CT. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.jofri.2014.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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83
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TASHIRO K, SHIOTANI S, KOBAYASHI T, KAGA K, SAITO H, SOMEYA S, MIYAMOTO K, HAYAKAWA H. Cerebral Relaxation Times from Postmortem MR Imaging of Adults. Magn Reson Med Sci 2015; 14:51-6. [DOI: 10.2463/mrms.2013-0126] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kazuya TASHIRO
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Seiji SHIOTANI
- Department of Radiology, Tsukuba Medical Center Hospital
| | - Tomoya KOBAYASHI
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Kazunori KAGA
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Hajime SAITO
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Satoka SOMEYA
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Katsumi MIYAMOTO
- Department of Radiological Technology, Tsukuba Medical Center Hospital
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84
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Morgan B, Adlam D, Robinson C, Pakkal M, Rutty GN. Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging. Br J Radiol 2014; 87:20130662. [PMID: 24338941 DOI: 10.1259/bjr.20130662] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The use of post-mortem imaging is expanding throughout the world with increasing use of advanced imaging techniques, such as contrast-enhanced CT and MRI. The questions asked of post-mortem imaging are complex and can be very different, for example for natural sudden death investigation will focus on the cause, whereas for trauma the cause of death is often clear, but injury patterns may be very revealing in investigating the background to the incident. Post-mortem imaging is different to clinical imaging regarding both the appearance of pathology and the information required, but there is much to learn from many years of clinical research in the use of these techniques. Furthermore, it is possible that post-mortem imaging research could be used not only for investigating the cause of death but also as a model to conduct clinically relevant research. This article reviews challenges to the development of post-mortem imaging for trauma, identification and cardiorespiratory death, and how they may be influenced by current clinical thinking and practice.
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Affiliation(s)
- B Morgan
- Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UK
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85
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Postmortem magnetic resonance imaging to guide the pathologic cut: individualized, 3-dimensionally printed cutting boxes for fixed brains. J Neuropathol Exp Neurol 2014; 73:780-8. [PMID: 25007244 DOI: 10.1097/nen.0000000000000096] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Interfacing magnetic resonance imaging (MRI) with pathology is critically important for understanding the pathologic basis of MRI signal changes in vivo and for clinicopathologic correlations. Postmortem MRI is an intermediate step in this process; unfortunately, however, relating the data to standard pathologic sections, which are relatively thick and often nonparallel, is both time-consuming and insufficiently accurate. The aim of this project was to develop technology to integrate postmortem, high-resolution, whole-brain MRI into the planning and execution of pathologic analysis through precise localization of the target and coordinates of cut. Compared with standard pathologic sectioning, the use of an individualized, 3-dimensionally printed cutting box-designed based on postmortem MRI of formalin-fixed whole brains-improved the speed, quality, and accuracy of radiologic-pathologic correlations and, specifically, the histopathologic localization of imaging findings. The technology described herein is easily implemented, applicable to any brain disorder, and potentially extendable to other organs. From the point of view of the pathologist, this technique can improve localization of small or subtle abnormalities, whereas from the point of view of the radiologist, it has the potential to improve understanding of MRI signal changes observed in diseases.
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