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Panzer S, Paladin A, Zesch S, Rosendahl W, Augat P, Thompson RC, Miyamoto MI, Sutherland ML, Allam AH, Wann LS, Sutherland JD, Rowan CJ, Michalik DE, Hergan K, Zink AR. Preservation of the heart in ancient Egyptian mummies: A computed tomography investigation with focus on the myocardium. Clin Anat 2024; 37:587-601. [PMID: 38566474 DOI: 10.1002/ca.24151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/02/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024]
Abstract
The ancient Egyptians considered the heart to be the most important organ. The belief that the heart remained in the body is widespread in the archeological and paleopathological literature. The purpose of this study was to perform an overview of the preserved intrathoracic structures and thoracic and abdominal cavity filling, and to determine the prevalence and computed tomography (CT) characteristics of the myocardium in the preserved hearts of ancient Egyptian mummies. Whole-body CT examinations of 45 ancient Egyptian mummies (23 mummies from the Ägyptisches Museum und Papyrussammlung, Berlin, Germany, and 22 mummies from the Museo Egizio, Turin, Italy) were systematically assessed for preserved intrathoracic soft tissues including various anatomical components of the heart (pericardium, interventricular septum, four chambers, myocardium, valves). Additionally, evidence of evisceration and cavity filling was documented. In cases with identifiable myocardium, quantitative (measurements of thickness and density) and qualitative (description of the structure) assessment of the myocardial tissue was carried out. Heart structure was identified in 28 mummies (62%). In 33 mummies, CT findings demonstrated evisceration, with subsequent cavity filling in all but one case. Preserved myocardium was identified in nine mummies (five male, four female) as a mostly homogeneous, shrunken structure. The posterior wall of the myocardium had a mean maximum thickness of 3.6 mm (range 1.4-6.6 mm) and a mean minimum thickness of 1.0 mm (range 0.5-1.7 mm). The mean Hounsfield units (HU) of the myocardium at the posterior wall was 61 (range, 185-305). There was a strong correlation between the HU of the posterior wall of the myocardium and the mean HU of the muscles at the dorsal humerus (R = 0.77; p = 0.02). In two cases, there were postmortem changes in the myocardium, most probably due to insect infestation. To our knowledge, this is the first study to investigate the myocardium systematically on CT scans of ancient Egyptian mummies. Strong correlations between the densities of the myocardium and skeletal muscle indicated similar postmortem changes of the respective musculature during the mummification process within individual mummies. The distinct postmortem shrinking of the myocardium and the collapse of the left ventriclular cavity in several cases did not allow for paleopathological diagnoses such as myocardial scarring.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
- Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany and Paracelsus Medical University, Salzburg, Austria
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
| | | | | | - Peter Augat
- Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany and Paracelsus Medical University, Salzburg, Austria
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Michael I Miyamoto
- Division of Cardiology, Mission Heritage Medical Group, Providence Health, Mission Viejo, California, USA
| | - M Linda Sutherland
- Division of Cardiovascular Diseases, MemorialCare Health System, Laguna Hills, California, USA
| | - Adel H Allam
- Department of Cardiology, Al Azhar University, Cairo, Egypt
| | - L Samuel Wann
- Division of Cardiology, University of New Mexico, Albuquerque, New Mexico, USA
| | - James D Sutherland
- Division of Cardiovascular Diseases, MemorialCare Health System, Laguna Hills, California, USA
| | - Chris J Rowan
- Division of Cardiovascular Diseases, University of Nevada, Reno, Reno, Nevada, USA
| | - David E Michalik
- Department of Pediatrics, Irvine School of Medicine, University of California, Orange, California, USA
| | - Klaus Hergan
- Department of Radiology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Albert R Zink
- Institute for Mummy Studies, Eurac Research, Bolzano, Italy
- Department of Biology II, Anthropology, Ludwig-Maximilians University Munich, Munich, Germany
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Panzer S, Zesch S, Rosendahl W, Thompson RC, Zink AR. Postmortem changes in ancient Egyptian child mummies: Possible pitfalls on CT images. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 42:46-54. [PMID: 37544242 DOI: 10.1016/j.ijpp.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To identify and interpret computed tomography (CT) findings of postmortem changes in ancient Egyptian child mummies. MATERIALS Whole-body CT examinations of 21 ancient Egyptian child mummies from German (n = 18), Italian (n = 1), and Swiss museums (n = 2). METHODS Conspicuous CT findings from prior evaluations with various research questions that were assessed as postmortem changes were classified, and special cases were illustrated and discussed. RESULTS Postmortem changes were classified into several categories. From these, individuals with evidence of invasion of resin/oil/tar into bone, dried fluid-levels within bone most likely due to natron, probable interaction of natron with soft tissues and bone, as well as insect infestation were demonstrated. CONCLUSIONS One challenge of paleoradiology is to differentiate between intravital and postmortem changes, which can be multifarious. These changes can be obvious, but also subtle, and can mimic diseases. SIGNIFICANCE The provided classification of postmortem changes, as well as the demonstrated cases, may serve as models for further paleoradiological investigations. The dried intraosseous fluid levels in two mummies, most likely due to natron, suggests that these children were immersed in a liquid natron bath, in contrast to the current scientific view that natron for mummification was routinely applied in the solid form. LIMITATIONS CT was used as the only examination method, as sampling of the mummies was not possible. SUGGESTIONS FOR FURTHER RESEARCH The awareness that postmortem changes on CT images of ancient Egyptian mummies might mimic pathology should be raised to reduce or avoid incorrect interpretation.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Prof-Küntscher-Straße 8, D-82418 Murnau, Germany; Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau and Paracelsus Medical University, Salzburg, Austria, Prof-Küntscher-Straße 8 D-82418 Murnau, Germany.
| | - Stephanie Zesch
- German Mummy Project, Reiss-Engelhorn-Museen, Museum Weltkulturen D5, D-68159 Mannheim, Germany
| | - Wilfried Rosendahl
- German Mummy Project, Reiss-Engelhorn-Museen, Museum Weltkulturen D5, D-68159 Mannheim, Germany
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, 4330 Wornall Road, Kansas City, MO 64111, USA
| | - Albert R Zink
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, I-39100 Bolzano, Italy
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Giovannetti G, Guerrini A, Minozzi S, Panetta D, Salvadori PA. Computer tomography and magnetic resonance for multimodal imaging of fossils and mummies. Magn Reson Imaging 2022; 94:7-17. [PMID: 36084902 DOI: 10.1016/j.mri.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/24/2022]
Abstract
The study of fossils and mummies has largely benefited from the use of modern noninvasive and nondestructive imaging technologies and represents a fast developing area. In this review, we describe the emerging role of imaging based on Magnetic Resonance (MR) and Computer Tomography (CT) employed for the study of ancient remains and mummies. For each methodology, the state of the art in paleoradiology applications is described, by emphasizing new technologies developed in the field of both CT, such as micro- and nano-CT, dual-energy and multi-energy CT, and MR, with the description of novel dedicated sequences, radiofrequency coils and gradients. The complementarity of CT and MR in paleoradiology is also discussed, by pointing out what MR provides in addition to CT, with an overview on the state of the art of emerging strategies in the use of CT/MR combination for the study of a sample following a multimodal integrated approach.
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Affiliation(s)
- Giulio Giovannetti
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy.
| | - Andrea Guerrini
- Gruppo Archeologico e Paleontologico Livornese, Museo di Storia Naturale del Mediterraneo, via Roma, 234, 57127 Leghorn, Italy
| | - Simona Minozzi
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 57, 56100 Pisa, Italy
| | - Daniele Panetta
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy
| | - Piero A Salvadori
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy
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Panzer S, Treitl M, Zesch S, Rosendahl W, Helmbold-Doyé J, Thompson RC, Zink AR. Radiological evidence of purulent infections in ancient Egyptian child mummies. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 36:30-35. [PMID: 34974252 DOI: 10.1016/j.ijpp.2021.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/26/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To identify computed tomography (CT) findings of purulent infections in ancient Egyptian child mummies. MATERIALS Whole-body CT examination of 21 ancient Egyptian child mummies from German (n = 18), Italian (n = 1), and Swiss museums (n = 2). METHODS CT examinations were evaluated for estimation of age at death and sex of the children. CT examinations were systematically assessed for any CT findings of purulent infection. RESULTS The estimated age at death of the children ranged from about one year to the age of 12-14 years (mean 4.8 years). Twelve children were assessed as male, seven as female and in two sex was indeterminate. Three out of 21 child mummies (14.3%) had radiological evidence of purulent infections. In one mummy, a bandage-like structure at the right lower leg was detected that most likely represented a dressing of a skin lesion. CONCLUSIONS This study appears to be the first to describe radiologically visualized structures consistent with dried pus in ancient Egyptian mummies. This study also appears to be the first to physically demonstrate an original ancient Egyptian dressing. SIGNIFICANCE These cases may serve as models for further paleopathological investigation. The evidence of an original dressing contributes to our knowledge of ancient Egyptian medicine. LIMITATIONS CT was used as the only examination method as sampling of the wrapped mummies was not possible. SUGGESTIONS FOR FURTHER RESEARCH Radiological-pathological correlation in mummies in which physical sampling is available may reveal further insights into purulent infections in ancient Egypt.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Prof-Küntscher-Straße 8, D-82418 Murnau, Germany; Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau and Paracelsus Medical University, Salzburg, Austria, Prof-Küntscher-Straße 8, D-82418 Murnau, Germany.
| | - Marcus Treitl
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Prof-Küntscher-Straße 8, D-82418 Murnau, Germany.
| | - Stephanie Zesch
- German Mummy Project, Reiss-Engelhorn-Museen, Museum Weltkulturen D5, D-68159 Mannheim, Germany.
| | - Wilfried Rosendahl
- German Mummy Project, Reiss-Engelhorn-Museen, Museum Weltkulturen D5, D-68159 Mannheim, Germany.
| | - Jana Helmbold-Doyé
- Ägyptisches Museum und Papyrussammlung, Staatliche Museen zu Berlin, Geschwister-Scholl-Str. 6, D-10117 Berlin, Germany.
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, 4330 Wornall Road, Kansas City, MO 64111, USA.
| | - Albert R Zink
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, I-39100 Bolzano, Italy.
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Panzer S, Augat P, Sprenger M, Zesch S, Rosendahl W, Sutherland ML, Thompson RC, Paladin A, Zink AR. Correlation of atherosclerosis and osteoarthritis in ancient Egypt: A standardized evaluation of 45 whole-body CT examinations. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 33:137-145. [PMID: 33930634 DOI: 10.1016/j.ijpp.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/01/2021] [Accepted: 04/04/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To correlate atherosclerosis (Ath) and osteoarthritis (OA) in mummies from ancient Egypt. MATERIALS Whole-body CT examinations of 23 mummies from the Ägyptisches Museum und Papyrussammlung, Berlin, Germany, and 22 mummies from the Museo Egizio, Turin, Italy. METHODS Ath was assessed in five anatomical regions by means of preserved arterial calcifications. OA was assessed using the Kellgren and Lawrence (1957) classification. RESULTS Statistical analysis revealed no correlation between Ath and total OA. A significant association was found for Ath and the upper limb group for OA grade >1 and for Ath and the lower limb group, consisting mainly of the hip and knee, for OA grade >2 OA. CONCLUSIONS The association of Ath and advanced OA of the hip and knee is comparable in prevalence to those reported in recent clinical studies, despite the low life expectancy and the different environment and lifestyle of the ancient Egyptians. SIGNIFICANCE This is the first study to correlate findings of Ath and OA in ancient Egypt statistically. The diseases of Ath and OA are common ailments with enormous and increasing impacts on public health. LIMITATIONS The large number of cardiovascular diseases was indicated only by arterial calcifications that resisted the post-mortem changes of the mummification process. Also, the assessed OA was on radiological OA. SUGGESTIONS FOR FURTHER RESEARCH Genomic studies of ancient Egyptian mummies may reveal genetic risk factors for Ath and OA that could be shared in ancient and modern populations.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Berufsgenossenschaftliche Unfallklinik Murnau, Prof-Küntscher-Strasse 8, D-82418 Murnau, Germany; Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau and Paracelsus Medical University, Salzburg, Austria, Prof-Küntscher-Strasse 8, D-82418 Murnau, Germany.
| | - Peter Augat
- Institute of Biomechanics, Berufsgenossenschaftliche Unfallklinik Murnau and Paracelsus Medical University, Salzburg, Austria, Prof-Küntscher-Strasse 8, D-82418 Murnau, Germany.
| | - Martin Sprenger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Universitätsplatz 4/3, A-8010 Graz, Austria.
| | - Stephanie Zesch
- German Mummy Project, Reiss-Engelhorn-Museen Mannheim, Zeughaus C5, D-68159 Mannheim, Germany.
| | - Wilfried Rosendahl
- German Mummy Project, Reiss-Engelhorn-Museen Mannheim, Zeughaus C5, D-68159 Mannheim, Germany.
| | - M Linda Sutherland
- MemorialCare Health Systems, 18035 Brookhurst St, Fountain Valley, California, USA.
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, 4330 Wornall Road, Kansas City, MO 6411, USA.
| | - Alice Paladin
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, I-39100 Bolzano, Italy.
| | - Albert R Zink
- Institute for Mummy Studies, Eurac Research, Viale Druso 1, I-39100 Bolzano, Italy.
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Tomov N. Impregnation is an essential part of mummification. Anat Rec (Hoboken) 2020; 304:518-519. [PMID: 32445508 DOI: 10.1002/ar.24455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/29/2020] [Accepted: 04/02/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Nikola Tomov
- Institute of Anatomy, University of Bern, Bern, Switzerland
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Morozova I, Öhrström LM, Eppenberger P, Bode-Lesniewska B, Gascho D, Haas C, Akgül G, Neukamm J, Röthlin KA, Imhof A, Shved N, Papageorgopoulou C, Rühli FJ. Ongoing tissue changes in an experimentally mummified human leg. Anat Rec (Hoboken) 2019; 303:3085-3095. [PMID: 31837087 DOI: 10.1002/ar.24333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 11/11/2022]
Abstract
Artificial mummification has been used since antiquity and is best known from ancient Egypt. Despite ancient Egyptian mummies being studied for several decades, the mummification techniques of that time are not well understood. Modern mummification experiments involving animal and human tissues have contributed additional insights relevant to a broad field of research. In the current study, we present follow-up results of an experiment on artificial mummification, which began in 2009. A human leg was artificially mummified and monitored for almost a year with histological, molecular, and radiological techniques. Since then, it has remained in a dry, natron salt blend for 9 years. The current analyses show further progression of dehydration and tissue alterations, as well as DNA degradation, suggesting an ongoing process. Our results add new insights into the mechanisms of tissue mummification. Taking into account that the process is still ongoing, further research is required, including a re-evaluation of the human leg in the future.
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Affiliation(s)
- Irina Morozova
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Lena M Öhrström
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Patrick Eppenberger
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Beata Bode-Lesniewska
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Dominic Gascho
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Cordula Haas
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Gülfirde Akgül
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Judith Neukamm
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Institute for Archaeological Sciences, University of Tübingen, Tübingen, Germany.,Center for Bioinformatics Tübingen, University of Tübingen, Tübingen, Germany
| | - Kim A Röthlin
- Institute of Medical Microbiology, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Alexander Imhof
- SRO AG, Spital Langenthal, Department of Internal Medicine, Langenthal, Switzerland
| | - Natallia Shved
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christina Papageorgopoulou
- Laboratory of Physical Anthropology, Department of History and Ethnology, Democritus University of Thrace, Komotini, Greece
| | - Frank J Rühli
- Institute of Evolutionary Medicine, Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Panzer S, Ketterl S, Bicker R, Schoske S, Nerlich AG. How to CT scan human mummies: Theoretical considerations and examples of use. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 26:122-134. [PMID: 31362163 DOI: 10.1016/j.ijpp.2019.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this study was to develop and provide recommendations for computed tomography (CT) examinations of human mummies. MATERIALS AND METHODS Based on theoretical considerations and examples, recommendations for use are provided for scanning and image reconstruction parameters. Four examples are presented to illustrate the effect of different CT parameters on image quality. RESULTS The use of appropriate scanning parameters (detector collimation, pitch factor, rotation time) is known to improve image quality; technical considerations favor using lower tube voltage and higher tube current values for the purposes of scanning of human mummies. The use of appropriate image reconstruction parameters (slice thickness, increment, field of view, reconstruction filters) are the basis for individual reconstructions for the purpose of evaluation, documentation, illustration and data storage. CONCLUSIONS Downsizing the field of view to the region of interest as done in the clinical radiological routine represents one major tool to improve image quality. SIGNIFICANCE The provided recommendations should improve CT image quality in mummy studies as well as the handling of image data for reconstructions and storage. LIMITATIONS The recommendations for CT scanning parameters and image reconstructions were written with relatively new generation CT scanners in mind. Only a few examples of use were chosen and image quality assessment was performed subjectively and not by quantitative measurements.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Prof-Küntscher-Strasse 8, D-82418 Murnau, Germany; Institute of Biomechanics, Trauma Center Murnau and Paracelsus Medical University, Salzburg, Austria, Prof-Küntscher-Strasse 8, D-82418 Murnau, Germany.
| | - Sieglinde Ketterl
- Siemens Healthcare GmbH, Europe, Middle East & Africa, Central Western Europe, Otto-Hahn-Ring 6, D-81739 Munich, Germany.
| | - Roxane Bicker
- State Museum of Egyptian Art, Gabelsbergerstrasse 35, D-80333 Munich, Germany.
| | - Sylvia Schoske
- State Museum of Egyptian Art, Gabelsbergerstrasse 35, D-80333 Munich, Germany.
| | - Andreas G Nerlich
- Institute of Pathology, Academic Clinics München-Bogenhausen and München-Schwabing Englschalkingerstrasse 77, D-81925 Munich, Germany.
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Panzer S, Thompson RC, Hergan K, Zink AR, Piombino-Mascali D. Evidence of aortic dissection and Marfan syndrome in a mummy from the Capuchin Catacombs of Palermo, Sicily. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 22:78-85. [PMID: 29890445 DOI: 10.1016/j.ijpp.2018.05.002] [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] [Received: 03/13/2018] [Revised: 05/15/2018] [Accepted: 05/19/2018] [Indexed: 06/08/2023]
Abstract
The authors report on the assessment of an anthropogenic mummy of a young man from the Capuchin Catacombs of Palermo, Sicily, tentatively dated from the mid- to late 19th century AD. The mummy was investigated by full-body CT examination. CT images clearly showed aortic dissection classified as Stanford-A. Due to the relation of aortic dissection to inherited connective tissue diseases in young people, such as Marfan syndrome, conspicuous and pathological findings possibly indicating the presence of underlying Marfan syndrome were assessed. Several systemic features were scored that supported the presence of underlying Marfan syndrome in this mummy. These findings were: pectus carinatum and chest asymmetry, dural ectasia, protrusio acetabuli, dolichocephaly, down-slanting palpebral fissures, malar hypoplasia and (probable) reduced elbow extension. Aortic dissection, a cardinal feature of Marfan syndrome, turned out to be the diagnostic key for the paleoradiological diagnosis of this disease. The demonstrated CT findings contribute to the spectrum of cardiovascular diseases and inherited connective tissue disease in the fields of paleopathology and paleoradiology.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Prof.-Küntscher-Straße 8, D-82418 Murnau, Germany; Institute of Biomechanics, Trauma Center Murnau and Paracelsus Medical University, Salzburg, Prof.-Küntscher-Straße 8, D-82418, Murnau, Germany.
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, 4401 Wornall Road, Kansas City, MO, 64111, USA.
| | - Klaus Hergan
- Division of Radiology, SALK, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft mbH, Paracelsus Medical University, Salzburg, Müllner Hauptstraße 48, A-5020 Salzburg, Austria.
| | - Albert R Zink
- EURAC-Institute for Mummy Studies, Viale Druso 1, I-39100 Bolzano, Italy.
| | - Dario Piombino-Mascali
- Department of Anatomy, Histology and Anthropology, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, LT-03101, Vilnius, Lithuania.
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Panzer S, Augat P, Zink AR, Piombino-Mascali D. CT checklist and scoring system for the assessment of soft tissue preservation in human mummies: application to catacomb mummies from Palermo, Sicily. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 20:50-59. [PMID: 29496216 DOI: 10.1016/j.ijpp.2018.01.003] [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] [Received: 08/08/2017] [Revised: 12/16/2017] [Accepted: 01/14/2018] [Indexed: 06/08/2023]
Abstract
In this study we applied the recently developed "Checklist and Scoring System for the Assessment of Soft Tissue Preservation in Human Mummies" to catacomb mummies from Palermo, Sicily. Data from twenty-three full-body computed tomography (CT) examinations were available. These consisted of seventeen adults and six children dating from the late 18th to the late 19th centuries AD. Seventeen of these mummies were anthropogenically mummified, and six spontaneously. Based on the checklist and scoring system, soft tissue preservation varied between both mummification groups, among mummies with the same type of mummification, and within individual mummies at different anatomical locations. Checkpoints of the main category "A. Soft Tissues of Head and Musculoskeletal System" were clearly more frequent than checkpoints of the main category "B. Organs and Organ Systems". Among the anthropogenic mummies, intra-arterial filling achieved the highest preservation status of organs and organ systems. Despite the small sample size, the statistical evaluation showed significant differences between mummification types, with the highest soft tissue preservation found in anthropogenic mummies. Application of the "Checklist" allowed a standardized assessment and documentation of the soft tissue preservation of these mummies. The "Scoring System" facilitated a comparison among mummification groups and mummies by means of numeric values.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Prof.-Küntscher-Strasse 8, D-82418 Murnau, Germany; Institute of Biomechanics, Trauma Center Murnau and Paracelsus Medical University Salzburg, Prof.-Küntscher-Strasse 8, D-82418 Murnau, Germany.
| | - Peter Augat
- Institute of Biomechanics, Trauma Center Murnau and Paracelsus Medical University Salzburg, Prof.-Küntscher-Strasse 8, D-82418 Murnau, Germany.
| | - Albert R Zink
- EURAC-Institute for Mummies and the Iceman, Viale Druso 1, I-39100 Bolzano, Italy.
| | - Dario Piombino-Mascali
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, LT-03101, Vilnius, Lithuania.
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Panzer S, Wittig H, Zesch S, Rosendahl W, Blache S, Müller-Gerbl M, Hotz G. Evidence of neurofibromatosis type 1 in a multi-morbid Inca child mummy: A paleoradiological investigation using computed tomography. PLoS One 2017; 12:e0175000. [PMID: 28403237 PMCID: PMC5389647 DOI: 10.1371/journal.pone.0175000] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/17/2017] [Indexed: 12/18/2022] Open
Abstract
Objective In this study, an Inca bundle was examined using computed tomography (CT). The primary aim was to determine the preservation status of bony and soft tissues, the sex, the age at the time of death, possible indicators for disease or even the cause of death, as well as the kind of mummification. A secondary aim was to obtain a brief overview of the wrapping in order to gain additional information on the cultural background. Materials and methods The bundle belongs to the Museum of Cultures in Basel, Switzerland, and was bought in Munich, Germany, in 1921. Radiocarbon dating of the superficial textile yielded a calibrated age between 1480 and 1650 AD. The mummy was investigated using multi-slice CT with slice thickness of 0.75 mm and 110 kilovolt. For standardized assessment of soft tissue preservation, a recently developed checklist was applied. Results CT revealed the mummy of a seven to nine year old boy with superior preservation of bony and soft tissues allowing detailed assessment. Indicators of neurofibromatosis type 1 (paravertebral and cutaneous neurofibromas, a breast neurofibroma, sphenoid wing dysplasia), Chagas disease (dilatation of the esophagus, stomach, rectum, and large amounts of feces), and lung infection (pleural adherence, calcifications), probably due to tuberculosis, were found. Furthermore, signs of peri-mortem violence (transection of the chest and a defect in the abdominal wall) were detected. CT images revealed a carefully performed wrapping. Conclusion CT examination of the Inca bundle proved to be an important non-destructive examination method. Standardized assessment, especially of the soft tissue structures, allowed for diagnoses of several diseases, indicating a multi-morbid child at the time of death. The careful wrapping pointed to a ceremonial burial. Within the cultural background, the signs of fatal violence were discussed as a possible result of war, murder, accident, or human sacrifice.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Murnau, Germany
- Institute of Biomechanics, Trauma Center Murnau and Paracelsus Medical University Salzburg, Murnau, Germany
- * E-mail:
| | - Holger Wittig
- Institute of Legal Medicine, University of Basel, Basel, Switzerland
| | - Stephanie Zesch
- German Mummy Project, Reiss-Engelhorn-Museen Mannheim, Mannheim, Germany
| | - Wilfried Rosendahl
- German Mummy Project, Reiss-Engelhorn-Museen Mannheim, Mannheim, Germany
| | | | | | - Gerhard Hotz
- Anthropology, Natural History Museum of Basel, Basel, Switzerland
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12
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Zesch S, Panzer S, Rosendahl W, Nance JW, Schönberg SO, Henzler T. From first to latest imaging technology: Revisiting the first mummy investigated with X-ray in 1896 by using dual-source computed tomography. Eur J Radiol Open 2016; 3:172-81. [PMID: 27504475 PMCID: PMC4968187 DOI: 10.1016/j.ejro.2016.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/02/2016] [Indexed: 12/18/2022] Open
Abstract
Purpose The aim of this study was to systematically reinvestigate the first human mummy that was ever analyzed with X-ray imaging in 1896, using dual-source computed tomography (DSCT) in order to compare the earliest and latest imaging technologies, to estimate preservation, age at death, sex, anatomical variants, paleopathological findings, mummification, embalming and wrapping of the child mummy from ancient Egypt. Radiocarbon dating was used to determine the mummy’s age and to specify the child’s living period in the Egyptian chronology. Material and methods The ancient Egyptian child mummy is kept in the Senckenberg Museum of Natural History in Frankfurt am Main, Germany. An accelerator mass spectrometer (MICADAS) was used for radiocarbon dating. DSCT was performed using a 2 × 64 slice dual-source CT system (Siemens Healthineers, Forchheim, Germany). A thorough visual examination of the mummy, a systematic radiological evaluation of the DICOM datasets, and established methods in physical anthropology were applied to assess the bio-anthropological data and the post mortem treatment of the body. Results Radiocarbon dating yielded a calibrated age between 378 and 235 cal BC (95.4% confidence interval), corresponding with the beginning of the Ptolemaic period. The mummy was a male who was four to five years old at the time of death. Remnants of the brain and inner organs were preserved by the embalmers, which is regularly observed in ancient Egyptian child mummies. Skin tissue, inner organs, tendons and/or musculature, cartilage, nerves and vasculature could be identified on the DSCT dataset. The dental health of the child was excellent. Anatomical variants and pathological defects included a congenital Pectus excavatum deformity, hepatomegaly, Harris lines, and longitudinal clefts in the ventral cortices of both femora. Conclusion Our results highlight the enormous progress achieved form earliest to latest imaging technology for advanced mummy research using the first human mummy investigated with X-ray. With the application of DSCT, detailed knowledge regarding age at death, sex, diseases, death, and mummification of a child from Ptolemaic Egypt are revealed while considering the temporary rites of body treatment and burial for children.
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Affiliation(s)
- Stephanie Zesch
- Reiss-Engelhorn-Museen, Museum Weltkulturen D5, 68159 Mannheim, Germany
- Corresponding author.
| | - Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Prof.-Kuentscher-Strasse 8, 82418 Murnau, Germany
- Institute of Biomechanics, Trauma Center Murnau and Paracelsus Medical University Salzburg, Prof.-Kuentscher-Strasse 8, 82418 Murnau, Germany
| | | | - John W. Nance
- Department of Radiology, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - Stefan O. Schönberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim—Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Thomas Henzler
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim—Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Giovannetti G, Guerrini A, Carnieri E, Salvadori PA. Magnetic resonance imaging for the study of mummies. Magn Reson Imaging 2016; 34:785-794. [PMID: 26979539 DOI: 10.1016/j.mri.2016.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/01/2016] [Accepted: 03/03/2016] [Indexed: 12/27/2022]
Abstract
Nondestructive diagnostic imaging for mummies study has a long tradition and high-resolution images of the samples morphology have been extensively acquired by using computed tomography (CT). However, although in early reports no signal or image was obtained because of the low water content, mummy magnetic resonance imaging (MRI) was demonstrated able to generate images of such ancient specimens by using fast imaging techniques. Literature demonstrated the general feasibility of nonclinical MRI for visualizing historic human tissues, which is particularly interesting for archeology. More recently, multinuclear magnetic resonance spectroscopy (MRS) was demonstrated able to detect numerous organic biochemicals from such remains. Although the quality of these images is not yet comparable to that of clinical magnetic resonance (MR) images, and further research will be needed for determining the full capacity of MR in this topic, the information obtained with MR can be viewed as complementary to the one provided by CT and useful for paleoradiological studies of mummies. This work contains an overview of the state of art of the emerging uses of MRI in paleoradiology.
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Affiliation(s)
- Giulio Giovannetti
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy.
| | - Andrea Guerrini
- Sezione Paleontologica GAPL (Gruppo Archeologico e Paleontologico Livornese), Museo di Storia Naturale del Mediterraneo, Via Roma, 234, 57127 Leghorn, Italy
| | - Emiliano Carnieri
- Sezione Paleontologica GAPL (Gruppo Archeologico e Paleontologico Livornese), Museo di Storia Naturale del Mediterraneo, Via Roma, 234, 57127 Leghorn, Italy
| | - Piero A Salvadori
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy
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Panzer S, Mc Coy MR, Hitzl W, Piombino-Mascali D, Jankauskas R, Zink AR, Augat P. Checklist and Scoring System for the Assessment of Soft Tissue Preservation in CT Examinations of Human Mummies. PLoS One 2015; 10:e0133364. [PMID: 26244862 PMCID: PMC4526695 DOI: 10.1371/journal.pone.0133364] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/25/2015] [Indexed: 12/12/2022] Open
Abstract
The purpose of this study was to develop a checklist for standardized assessment of soft tissue preservation in human mummies based on whole-body computed tomography examinations, and to add a scoring system to facilitate quantitative comparison of mummies. Computed tomography examinations of 23 mummies from the Capuchin Catacombs of Palermo, Sicily (17 adults, 6 children; 17 anthropogenically and 6 naturally mummified) and 7 mummies from the crypt of the Dominican Church of the Holy Spirit of Vilnius, Lithuania (5 adults, 2 children; all naturally mummified) were used to develop the checklist following previously published guidelines. The scoring system was developed by assigning equal scores for checkpoints with equivalent quality. The checklist was evaluated by intra- and inter-observer reliability. The finalized checklist was applied to compare the groups of anthropogenically and naturally mummified bodies. The finalized checklist contains 97 checkpoints and was divided into two main categories, “A. Soft Tissues of Head and Musculoskeletal System” and “B. Organs and Organ Systems”, each including various subcategories. The complete checklist had an intra-observer reliability of 98% and an inter-observer reliability of 93%. Statistical comparison revealed significantly higher values in anthropogenically compared to naturally mummified bodies for the total score and for three subcategories. In conclusion, the developed checklist allows for a standardized assessment and documentation of soft tissue preservation in whole-body computed tomography examinations of human mummies. The scoring system facilitates a quantitative comparison of the soft tissue preservation status between single mummies or mummy collections.
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Affiliation(s)
- Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Murnau, Germany
- Institute of Biomechanics, Trauma Center Murnau, Murnau, Germany, and Paracelsus Medical University, Salzburg, Austria
- * E-mail:
| | - Mark R. Mc Coy
- Division of Neuroradiology, SALK, Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft mbH, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Hitzl
- Biostatistics, Research office, Paracelsus Medical University, Salzburg, Austria
| | - Dario Piombino-Mascali
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Rimantas Jankauskas
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Albert R. Zink
- EURAC-Institute for Mummies and the Iceman, Bolzano, Italy
| | - Peter Augat
- Institute of Biomechanics, Trauma Center Murnau, Murnau, Germany, and Paracelsus Medical University, Salzburg, Austria
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Papageorgopoulou C, Shved N, Wanek J, Rühli FJ. Modeling Ancient Egyptian Mummification on Fresh Human Tissue: Macroscopic and Histological Aspects. Anat Rec (Hoboken) 2015; 298:974-87. [DOI: 10.1002/ar.23134] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/30/2015] [Indexed: 01/13/2023]
Affiliation(s)
- Christina Papageorgopoulou
- Department of History and Ethnology; Laboratory of Anthropology; Demokritus University of Thrace; Komotini Greece
| | - Natallia Shved
- Swiss Mummy Project, Centre for Evolutionary Medicine, Institute of Anatomy; University of Zurich; Zürich Switzerland
| | - Johann Wanek
- Swiss Mummy Project, Centre for Evolutionary Medicine, Institute of Anatomy; University of Zurich; Zürich Switzerland
| | - Frank J. Rühli
- Swiss Mummy Project, Centre for Evolutionary Medicine, Institute of Anatomy; University of Zurich; Zürich Switzerland
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Posh JC. Technical Limitations on the Use of Traditional Magnetic Resonance Imaging in the Evaluation of Mummified Remains: A View From a Hands-On Radiologic Technologist's Perspective. Anat Rec (Hoboken) 2015; 298:1116-24. [DOI: 10.1002/ar.23153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/30/2015] [Indexed: 12/29/2022]
Affiliation(s)
- John C. Posh
- Penn Medicine, Hospital of the University of Pennsylvania, Donner Basement; Philadelphia Pennsylvania
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Rühli FJ. Short Review: Magnetic Resonance Imaging of Ancient Mummies. Anat Rec (Hoboken) 2015; 298:1111-5. [DOI: 10.1002/ar.23150] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 01/30/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Frank J. Rühli
- Swiss Mummy Project, Centre for Evolutionary Medicine, Institute of Anatomy; University of Zurich; Winterthurerstr. 190 Zürich 8057 Switzerland
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Beckett RG. Paleoimaging: a review of applications and challenges. Forensic Sci Med Pathol 2014; 10:423-36. [DOI: 10.1007/s12024-014-9541-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 12/15/2022]
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