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Kojima M, Makino Y, Yamaguchi R, Motomura A, Yajima D, Inokuchi G, Saito N, Torimitsu S, Hoshioka Y, Urabe S, Yoshida M, Iwase H, Miyati T. Gray-white matter contrast reversal on T 1-weighted spin-echo in postmortem brain. Forensic Sci Int 2024; 360:112031. [PMID: 38723476 DOI: 10.1016/j.forsciint.2024.112031] [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: 08/14/2023] [Revised: 01/29/2024] [Accepted: 04/18/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE The image contrast of postmortem magnetic resonance imaging (MRI) may differ from that of antemortem MRI because of circulator arrest, changes in postmortem tissue, and low-body-temperature scanning conditions. In fact, we have found that the signal intensity of white matter (WM) on T1-weighted spin-echo (T1WSE) images of the postmortem brain was lower than that of gray matter (GM), which resulted in image contrast reversal between GM and WM relative to the living brain. However, the reason for this phenomenon is unclear. Therefore, the aim of this study is to clarify the reason why image contrast reversal occurs between GM and WM of the postmortem brain. MATERIALS AND METHODS Twenty-three corpses were included in the study (mean age, 60.6 years; range: 19-60 years; mean rectal temperature at scan, 6.9℃; range: 4-11℃). On a 1.5 T MRI system, postmortem T1W-SE MRI of the brain was conducted in the 23 corpses prior to medico-legal autopsy. Next, T1 and T2 of the GM and WM at the level of the basal ganglia were determined in the same participants using inversion recovery and multiple SE sequences, respectively. The proton density (PD) was also calculated from the T1 and T2 images (in the same slice). RESULTS T1W-SE image contrast between the GM and WM of all postmortem brains was inverted relative to the living brain. T1 (579 ms in GM and 307 ms in WM) and PD (64 in GM and 44 in WM) of the postmortem brain decreased compared with the living brain. While T1 of WM/GM remained below 1 even postmortem, the PD of WM/GM decreased. T2 (110 ms in GM and 98 ms in WM) of the postmortem brain did not differ from the living brain. CONCLUSION The decrease in PD of WM/GM in the postmortem brain may be the major driver of contrast reversal between the GM and WM relative to the living brain.
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Affiliation(s)
- Masatoshi Kojima
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
| | - Yohsuke Makino
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Ayumi Motomura
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Forensic Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita-city, Chiba 286-8686, Japan
| | - Daisuke Yajima
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Forensic Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita-city, Chiba 286-8686, Japan
| | - Go Inokuchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Naoki Saito
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan
| | - Suguru Torimitsu
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yumi Hoshioka
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan
| | - Shumari Urabe
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, 4-21-18 Otusuka, Bunkyo-ku, Tokyo, Japan
| | - Maiko Yoshida
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Tosiaki Miyati
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Gascho D, von Allmen A, Landsmann A, Hünermund T, Tappero C, Thali MJ, Deininger-Czermak E. Diagnostic value of T 1- and T 2-weighted 3-Tesla MRI for postmortem detection and age stage classification of myocardial infarction. Forensic Sci Med Pathol 2024; 20:14-22. [PMID: 36862287 PMCID: PMC10944381 DOI: 10.1007/s12024-023-00592-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 03/03/2023]
Abstract
The aims of this study are to retrospectively evaluate the diagnostic value of T1- and T2-weighted 3-T magnetic resonance imaging (MRI) for postmortem detection of myocardial infarction (MI) in terms of sensitivity and specificity and to compare the MRI appearance of the infarct area with age stages. Postmortem MRI examinations (n = 88) were retrospectively reviewed for the presence or absence of MI by two raters blinded to the autopsy results. The sensitivity and specificity were calculated using the autopsy results as the gold standard. A third rater, who was not blinded to the autopsy findings, reviewed all cases in which MI was detected at autopsy for MRI appearance (hypointensity, isointensity, hyperintensity) of the infarct area and the surrounding zone. Age stages (peracute, acute, subacute, chronic) were assigned based on the literature and compared with the age stages reported in the autopsy reports. The interrater reliability between the two raters was substantial (κ = 0.78). Sensitivity was 52.94% (both raters). Specificity was 85.19% and 92.59%. In 34 decedents, autopsy identified an MI (peracute: n = 7, acute: n = 25, chronic: n = 2). Of 25 MI classified as acute at autopsy, MRI classified peracute in four cases and subacute in nine cases. In two cases, MRI suggested peracute MI, which was not detected at autopsy. MRI could help to classify the age stage and may indicate the area for sampling for further microscopic examination. However, the low sensitivity requires further additional MRI techniques to increase the diagnostic value.
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Affiliation(s)
- Dominic Gascho
- Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
| | - Alexandre von Allmen
- Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Anna Landsmann
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Tobias Hünermund
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Carlo Tappero
- Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
- Department of Radiology, Hôpital Fribourgeois, Fribourg, Switzerland
| | - Michael J Thali
- Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Eva Deininger-Czermak
- Department of Forensic Medicine and Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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Berger C, Bauer M, Scheurer E, Lenz C. Temperature correction of post mortem quantitative magnetic resonance imaging using real-time forehead temperature acquisitions. Forensic Sci Int 2023; 348:111738. [PMID: 37263059 DOI: 10.1016/j.forsciint.2023.111738] [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: 12/22/2022] [Revised: 04/24/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
Performing magnetic resonance imaging (MRI) of deceased is challenging due to altered body temperatures compared to in vivo temperatures and, hence, requires a temperature correction. This study investigates the possibility to correct brain MRI parameters real-time and non invasively based on the forehead temperature. 17 post mortem cases were included and their forehead temperatures were measured continuously during the in situ brain MRI protocol consisting of a diffusion tensor imaging, multi-contrast spin echo, multi-echo gradient echo and inversion recovery spin echo sequence. Linear models were fitted to the quantitative MRI parameters in a forensically interesting temperature range for white matter, cerebral cortex and deep gray matter, separately, and the influence of the forehead temperature on the MRI parameters was determined. A statistically significant temperature sensitivity was found for T2 and mean diffusivity in white matter, for T1 in cerebral cortex, as well as for T1 and mean diffusivity in deep gray matter. Linear models were computed to temperature correct these MRI parameters in in situ post mortem scans to allow their comparison regardless of temperature. The here presented real-time and non invasive temperature correction method for the brain presents a crucial precondition for quantitative in situ post mortem MRI.
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Affiliation(s)
- Celine Berger
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Melanie Bauer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Eva Scheurer
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Claudia Lenz
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.
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Michaud K, Jacobsen C, Basso C, Banner J, Blokker BM, de Boer HH, Dedouit F, O'Donnell C, Giordano C, Magnin V, Grabherr S, Suvarna SK, Wozniak K, Parsons S, van der Wal AC. Application of postmortem imaging modalities in cases of sudden death due to cardiovascular diseases-current achievements and limitations from a pathology perspective : Endorsed by the Association for European Cardiovascular Pathology and by the International Society of Forensic Radiology and Imaging. Virchows Arch 2023; 482:385-406. [PMID: 36565335 PMCID: PMC9931788 DOI: 10.1007/s00428-022-03458-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 12/25/2022]
Abstract
Postmortem imaging (PMI) is increasingly used in postmortem practice and is considered a potential alternative to a conventional autopsy, particularly in case of sudden cardiac deaths (SCD). In 2017, the Association for European Cardiovascular Pathology (AECVP) published guidelines on how to perform an autopsy in such cases, which is still considered the gold standard, but the diagnostic value of PMI herein was not analyzed in detail. At present, significant progress has been made in the PMI diagnosis of acute ischemic heart disease, the most important cause of SCD, while the introduction of postmortem CT angiography (PMCTA) has improved the visualization of several parameters of coronary artery pathology that can support a diagnosis of SCD. Postmortem magnetic resonance (PMMR) allows the detection of acute myocardial injury-related edema. However, PMI has limitations when compared to clinical imaging, which severely impacts the postmortem diagnosis of myocardial injuries (ischemic versus non-ischemic), the age-dating of coronary occlusion (acute versus old), other potentially SCD-related cardiac lesions (e.g., the distinctive morphologies of cardiomyopathies), aortic diseases underlying dissection or rupture, or pulmonary embolism. In these instances, PMI cannot replace a histopathological examination for a final diagnosis. Emerging minimally invasive techniques at PMI such as image-guided biopsies of the myocardium or the aorta, provide promising results that warrant further investigations. The rapid developments in the field of postmortem imaging imply that the diagnosis of sudden death due to cardiovascular diseases will soon require detailed knowledge of both postmortem radiology and of pathology.
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Affiliation(s)
- Katarzyna Michaud
- University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Christina Jacobsen
- Section of Forensic Pathology, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Cristina Basso
- Cardiovascular Pathology Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Jytte Banner
- Section of Forensic Pathology, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Hans H de Boer
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, Melbourne, Australia
| | - Fabrice Dedouit
- GRAVIT, Groupe de Recherche en Autopsie Virtuelle et Imagerie Thanatologique, Forensic Department, University Hospital, Rangueil, Toulouse, France
| | - Chris O'Donnell
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, Melbourne, Australia
| | - Carla Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Virginie Magnin
- University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Silke Grabherr
- University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - S Kim Suvarna
- Department of Histopathology, Northern General Hospital, The University of Sheffield, Sheffield, UK
| | - Krzysztof Wozniak
- Department of Forensic Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Sarah Parsons
- Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, Melbourne, Australia
| | - Allard C van der Wal
- Department of Pathology, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands.
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5
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Aquaro GD, Guidi B, Emdin M, Pucci A, Chiti E, Santurro A, Scopetti M, Biondi F, Maiese A, Turillazzi E, Camastra G, Faggioni L, Cioni D, Fineschi V, Neri E, Di Paolo M. Post-Mortem Cardiac Magnetic Resonance in Explanted Heart of Patients with Sudden Death. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013395. [PMID: 36293989 PMCID: PMC9603042 DOI: 10.3390/ijerph192013395] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND We sought to evaluate the diagnostic accuracy of post-mortem cardiac magnetic resonance (PMCMR) of explanted hearts to detect the cardiac causes of sudden death. METHODS PMCMR was performed in formalin-fixed explanted hearts of 115 cases of sudden death. Histological sampling of myocardium was performed using two different approaches: (1) guideline-based sampling; (2) guideline-based plus PMCMR-driven sampling. RESULTS Forensic diagnosis of cardiac cause of death was ascertained in 72 (63%) patients. When the guideline-driven histological sampling was used, the PMCMR interpretation matched with final forensic diagnosis in 93 out of 115 cases (81%) with sensitivity of 88% (79-95%), specificity of 65% (47-80%), PPV of 84% (78-90%), NPV of 73% (58-84%), accuracy of 81% (72-88%), and AUC of 0.77 (0.68-0.84). When a PMCMR-driven approach was added to the guideline-based one, the matching increased to 102 (89%) cases with a PMCMR sensitivity of 89% (80-94%), a specificity of 86% (67-96%), PPV of 95% (89-98%), NPV of 73% (59-83%), accuracy of 89% (81-93%), and AUC of 0.88 (0.80-0.93). CONCLUSIONS PMCMR has high accuracy to identify the cardiac cause of sudden death and may be considered a valid auxilium for forensic diagnosis. PMCMR could improve histological diagnosis in conditions with focal myocardial involvement or demonstrating signs of myocardial ischemia.
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Affiliation(s)
| | | | - Michele Emdin
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy
- Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Angela Pucci
- Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Enrica Chiti
- Department of Surgical, Clinical and Molecular Pathology and of Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Alessandro Santurro
- Department of Medicine, Surgery and Dentistry-Scuola Medica Salernitana, University of Salerno, 84084 Fisciano, Italy
| | - Matteo Scopetti
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
| | - Federico Biondi
- Cardiology Department, University of Trieste, 34127 Trieste, Italy
| | - Aniello Maiese
- UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
| | | | | | | | - Dania Cioni
- Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Neri
- Academic Radiology, University of Pisa, 56126 Pisa, Italy
| | - Marco Di Paolo
- UO Medicina Legale, University of Pisa, 56126 Pisa, Italy
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Stouthandel MEJ, Pullens P, Bogaert S, Schoepen M, Vangestel C, Achten E, Veldeman L, Van Hoof T. Application of frozen Thiel-embalmed specimens for radiotherapy delineation guideline development: a method to create accurate MRI-enhanced CT datasets. Strahlenther Onkol 2022; 198:582-592. [DOI: 10.1007/s00066-022-01928-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 03/10/2022] [Indexed: 11/30/2022]
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Tijssen MPM, Hofman PAM, Robben SGF. Postmortem Fetal Temperature Estimation with Magnetic Resonance Imaging: Apparent Diffusion Coefficient Measurements in the Vitreous Body and Cerebrospinal Fluid. Top Magn Reson Imaging 2022; 31:25-30. [PMID: 36269228 DOI: 10.1097/rmr.0000000000000295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) is increasingly used in postmortem fetal imaging. Several factors influence the quality of MRI in this setting, such as small size, autolytic and maceration changes, and temperature. Knowing the fetal temperature at the time of scanning can improve the MRI interpretation. Temperature can be calculated using diffusion-weighted imaging with measurements of the apparent diffusion coefficient (ADC) in the cerebrospinal fluid (CSF). However, this is complicated by small ventricle size and hemorrhage and, therefore, may be unreliable in postmortem imaging. The current study evaluated the feasibility and reliability of using the ADC for temperature measurements of the vitreous body compared to that of CSF. MATERIALS AND METHODS Two lambs were scanned postmortem at five different time points over 28 hours. Furthermore, 10 stillborn fetuses were scanned once, at 4 to 62 hours after birth. The temperature was measured with a digital thermometer and calculated using the ADCs of the vitreous body (lambs and fetuses) and CSF (fetuses). RESULTS There was an excellent correlation between measured and calculated temperatures in vitreous bodies of lambs (r = 0.997, P < 0.001) and fetuses (r = 0.970, P < 0.001). The correlation between measured and calculated temperatures in the CSF was poor (r = 0.522, P = 0.122). CONCLUSION The calculation of the temperature based on the ADC of the vitreous body is feasible and reliable for postmortem fetal imaging.
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Affiliation(s)
- Maud P M Tijssen
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
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Young LAJ, Ceresa CDL, Mózes FE, Ellis J, Valkovič L, Colling R, Coussios CC, Friend PJ, Rodgers CT. Noninvasive assessment of steatosis and viability of cold-stored human liver grafts by MRI. Magn Reson Med 2021; 86:3246-3258. [PMID: 34272767 PMCID: PMC7613197 DOI: 10.1002/mrm.28930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE A shortage of suitable donor livers is driving increased use of higher risk livers for transplantation. However, current biomarkers are not sensitive and specific enough to predict posttransplant liver function. This is limiting the expansion of the donor pool. Therefore, better noninvasive tests are required to determine which livers will function following implantation and hence can be safely transplanted. This study assesses the temperature sensitivity of proton density fat fraction and relaxometry parameters and examines their potential for assessment of liver function ex vivo. METHODS Six ex vivo human livers were scanned during static cold storage following normothermic machine perfusion. Proton density fat fraction, T1 , T2 , and T 2 ∗ were measured repeatedly during cooling on ice. Temperature corrections were derived from these measurements for the parameters that showed significant variation with temperature. RESULTS Strong linear temperature sensitivities were observed for proton density fat fraction (R2 = 0.61, P < .001) and T1 (R2 = 0.78, P < .001). Temperature correction according to a linear model reduced the coefficient of repeatability in these measurements by 41% and 36%, respectively. No temperature dependence was observed in T2 or T 2 ∗ measurements. Comparing livers deemed functional and nonfunctional during normothermic machine perfusion by hemodynamic and biochemical criteria, T1 differed significantly: 516 ± 50 ms for functional versus 679 ± 60 ms for nonfunctional, P = .02. CONCLUSION Temperature correction is essential for robust measurement of proton density fat fraction and T1 in cold-stored human livers. These parameters may provide a noninvasive measure of viability for transplantation.
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Affiliation(s)
- Liam A. J. Young
- Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Carlo D. L. Ceresa
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Ferenc E. Mózes
- Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Jane Ellis
- Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ladislav Valkovič
- Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Richard Colling
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Peter J. Friend
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Christopher T. Rodgers
- Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
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9
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Post mortem brain temperature and its influence on quantitative MRI of the brain. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:375-387. [PMID: 34714448 PMCID: PMC9188516 DOI: 10.1007/s10334-021-00971-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/28/2021] [Accepted: 10/15/2021] [Indexed: 11/24/2022]
Abstract
Objective MRI temperature sensitivity presents a major issue in in situ post mortem MRI (PMMRI), as the tissue temperatures differ from living persons due to passive cooling of the deceased. This study aims at computing brain temperature effects on the MRI parameters to correct for temperature in PMMRI, laying the foundation for future projects on post mortem validation of in vivo MRI techniques. Materials and methods Brain MRI parameters were assessed in vivo and in situ post mortem using a 3 T MRI scanner. Post mortem brain temperature was measured in situ transethmoidally. The temperature effect was computed by fitting a linear model to the MRI parameters and the corresponding brain temperature. Results Linear positive temperature correlations were observed for T1, T2* and mean diffusivity in all tissue types. A significant negative correlation was observed for T2 in white matter. Fractional anisotropy revealed significant correlations in all gray matter regions except for the thalamus. Discussion The linear models will allow to correct for temperature in post mortem MRI. Comparing in vivo to post mortem conditions, the mean diffusivity, in contrast to T1 and T2, revealed additional effects besides temperature, such as cessation of perfusion and active diffusion.
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10
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Arnold I, Schwendener N, Lombardo P, Jackowski C, Zech WD. 3Tesla post-mortem MRI quantification of anatomical brain structures. Forensic Sci Int 2021; 327:110984. [PMID: 34482282 DOI: 10.1016/j.forsciint.2021.110984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/04/2021] [Accepted: 08/17/2021] [Indexed: 01/31/2023]
Abstract
Quantitative post-mortem magnetic resonance imaging (PMMR) allows for measurement of T1 and T2 relaxation times and proton density (PD) of brain tissue. Quantitative PMMR values may be used for advanced post-mortem neuro-imaging diagnostics such as computer aided diagnosis. So far, the quantitative T1, T2 and PD post-mortem values of regular anatomical brain structures were unknown for a 3 Tesla PMMR application. The goal of this basic research study was to evaluate the quantitative values of post-mortem brain structures for a 3 T post-mortem magnetic resonance application with regard to various corpse temperatures. In 50 forensic cases, a quantitative PMMR brain sequence was applied prior to autopsy. Measurements of T1 (in ms), T2 (in ms), and PD (in %) values of cerebrum (Group 1: frontal grey matter, frontal white matter, thalamus, caudate nucleus, globus pallidus, putamen, internal capsule) brainstem and cerebellum (Group 2: cerebral peduncle, substantia nigra, red nucleus, pons, middle cerebellar peduncle, cerebellar hemisphere, medulla oblongata) were conducted in synthetically calculated axial PMMR brain images. Assessed quantitative values were corrected for corpse temperature. Temperature dependence was observed mainly for T1 values. ANOVA testing resulted in significant differences of quantitative values between the investigated anatomical brain structures in both groups. It can be concluded that temperature corrected 3 Tesla PMMR T1, T2 and PD values are feasible for characterization and discrimination of regular anatomical brain structures. This may provide a base for future advanced diagnostics of forensically relevant brain lesions and pathology.
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Affiliation(s)
- Isabel Arnold
- Institute of Forensic Medicine, University of Bern, Switzerland
| | | | - Paolo Lombardo
- Institute of Forensic Medicine, University of Bern, Switzerland; Department of Diagnostic, Interventional and Pediatric Radiology, University of Bern, Inselspital Bern, Switzerland
| | | | - Wolf-Dieter Zech
- Institute of Forensic Medicine, University of Bern, Switzerland.
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Zhang Q, Werys K, Popescu IA, Biasiolli L, Ntusi NAB, Desai M, Zimmerman SL, Shah DJ, Autry K, Kim B, Kim HW, Jenista ER, Huber S, White JA, McCann GP, Mohiddin SA, Boubertakh R, Chiribiri A, Newby D, Prasad S, Radjenovic A, Dawson D, Schulz-Menger J, Mahrholdt H, Carbone I, Rimoldi O, Colagrande S, Calistri L, Michels M, Hofman MBM, Anderson L, Broberg C, Andrew F, Sanz J, Bucciarelli-Ducci C, Chow K, Higgins D, Broadbent DA, Semple S, Hafyane T, Wormleighton J, Salerno M, He T, Plein S, Kwong RY, Jerosch-Herold M, Kramer CM, Neubauer S, Ferreira VM, Piechnik SK. Quality assurance of quantitative cardiac T1-mapping in multicenter clinical trials - A T1 phantom program from the hypertrophic cardiomyopathy registry (HCMR) study. Int J Cardiol 2021; 330:251-258. [PMID: 33535074 PMCID: PMC7994017 DOI: 10.1016/j.ijcard.2021.01.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/07/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Quantitative cardiovascular magnetic resonance T1-mapping is increasingly used for myocardial tissue characterization. However, the lack of standardization limits direct comparability between centers and wider roll-out for clinical use or trials. PURPOSE To develop a quality assurance (QA) program assuring standardized T1 measurements for clinical use. METHODS MR phantoms manufactured in 2013 were distributed, including ShMOLLI T1-mapping and reference T1 and T2 protocols. We first studied the T1 and T2 dependency on temperature and phantom aging using phantom datasets from a single site over 4 years. Based on this, we developed a multiparametric QA model, which was then applied to 78 scans from 28 other multi-national sites. RESULTS T1 temperature sensitivity followed a second-order polynomial to baseline T1 values (R2 > 0.996). Some phantoms showed aging effects, where T1 drifted up to 49% over 40 months. The correlation model based on reference T1 and T2, developed on 1004 dedicated phantom scans, predicted ShMOLLI-T1 with high consistency (coefficient of variation 1.54%), and was robust to temperature variations and phantom aging. Using the 95% confidence interval of the correlation model residuals as the tolerance range, we analyzed 390 ShMOLLI T1-maps and confirmed accurate sequence deployment in 90%(70/78) of QA scans across 28 multiple centers, and categorized the rest with specific remedial actions. CONCLUSIONS The proposed phantom QA for T1-mapping can assure correct method implementation and protocol adherence, and is robust to temperature variation and phantom aging. This QA program circumvents the need of frequent phantom replacements, and can be readily deployed in multicenter trials.
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Affiliation(s)
- Qiang Zhang
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK.
| | - Konrad Werys
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Iulia A Popescu
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Luca Biasiolli
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | | | | | - Dipan J Shah
- Houston Methodist DeBakey Heart & Vascular Center, USA
| | - Kyle Autry
- Houston Methodist DeBakey Heart & Vascular Center, USA
| | - Bette Kim
- Mount Sinai West Hospital; Icahn School of Medicine at Mount Sinai, USA
| | - Han W Kim
- Duke Cardiovascular Magnetic Resonance Center, Duke University Medical Center, USA
| | - Elizabeth R Jenista
- Duke Cardiovascular Magnetic Resonance Center, Duke University Medical Center, USA
| | - Steffen Huber
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, USA
| | - James A White
- Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute, University of Calgary, Canada
| | - Gerry P McCann
- Department of cardiovascular sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, UK
| | - Saidi A Mohiddin
- Inherited Cardiovascular Diseases, Barts Heart Centre, London, UK
| | - Redha Boubertakh
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, UK
| | - Amedeo Chiribiri
- King's College London and Guy's and St Thomas' NHS Foundation Trust, UK
| | - David Newby
- Centre for Cardiovascular Science, University of Edinburgh, UK
| | - Sanjay Prasad
- National Heart and Lung Institute, Imperial College and Royal Brompton Hospital, London, UK
| | - Aleksandra Radjenovic
- Institute of Cardiovascular & Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Dana Dawson
- Aberdeen Cardiovascular and Diabetes Centre, College of Life Sciences and Medicine, University of Aberdeen, UK
| | | | - Heiko Mahrholdt
- Department of Cardiology, Robert Bosch Medical Center, Stuttgart, Germany
| | - Iacopo Carbone
- Department of Radiological, Oncological and Pathological Sciences, Sapienza, University of Rome, Italy
| | | | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Italy
| | - Michelle Michels
- Erasmus MC, department of cardiology, Rotterdam, the Netherlands
| | - Mark B M Hofman
- dept. Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Lisa Anderson
- Cardiology Clinical Academic Group, St George's University of London, UK
| | - Craig Broberg
- Knight Cardiovascular Institute, Oregon Health and Science University, USA
| | | | | | | | - Kelvin Chow
- Siemens Medical Solutions USA, Inc., Chicago, IL, USA
| | | | - David A Broadbent
- Biomedical Imaging Sciences Department, University of Leeds, Leeds, UK
| | - Scott Semple
- Edinburgh Imaging, Centre for Cardiovascular Science, University of Edinburgh, UK
| | | | | | | | - Taigang He
- The Cardiology Clinical Academic Group (CAG), St George's University of London, St George's University Hospitals NHS Foundation Trust, UK
| | - Sven Plein
- Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, UK
| | - Raymond Y Kwong
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, USA
| | | | | | - Stefan Neubauer
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Vanessa M Ferreira
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
| | - Stefan K Piechnik
- Oxford Centre for Clinical Magnetic Resonance Research, Oxford BRC NIHR, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, UK
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12
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Tashiro K, Kobayashi T, Shiotani S, Saitou H, Kaga K, Someya S, Yoshida M, Yamamori M, Kamimura Y, Kuramochi R, Miyamoto K, Hayakawa H, Muranaka H, Homma K. Skeletal muscular relaxation time from postmortem MR imaging of adult humans. FORENSIC IMAGING 2020. [DOI: 10.1016/j.fri.2020.200399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Xia ZY, Bruguier C, Dedouit F, Grabherr S, Augsburger M, Liu BB. Oleic Acid (OA), A Potential Dual Contrast Agent for Postmortem MR Angiography (PMMRA): A Pilot Study. Curr Med Sci 2020; 40:786-794. [PMID: 32862391 DOI: 10.1007/s11596-020-2244-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/19/2020] [Indexed: 01/31/2023]
Abstract
Choosing proper perfusates as contrast agents is an important aspect for postmortem magnetic resonance angiography (PMMRA). However, in this emerging field, the number of suitable kinds of liquid is still very limited. The objective of this research is to compare MR images of oleic acid (OA) with paraffin oil (PO) in vitro and in ex situ animal hearts, in order to evaluate the feasibility to use OA as a novel contrast agent for PMMRA. In vitro, OA, PO and water (control) were introduced into three tubes separately and T1weighted-spin echo (T1w-SE) and T2w-SE images were acquired on a 1.5T MR scanner. In the second experiment, OA and PO were injected into left coronary artery (LCA) and left ventricle (LV) of ex situ bovine hearts and their T1w-SE, T2w-SE, T1w-multipoint Dixon (T1w-mDixon) and 3DT2w-mDixon images were acquired. The overall results indicate that OA may have a potential to be used as a dual (T1 and T2 based) contrast agent for PMMRA when proper sequence parameters are utilized. However, as the pilot study was based on limited number of animal hearts, more researches using OA in cadavers are needed to validate our findings.
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Affiliation(s)
- Zhi-Yuan Xia
- Institute of Evidence Law and Forensic Science, China University of Political Science and Law (CUPL), Key Laboratory of Evidence Law and Forensic Science, Ministry of Education, Beijing, 100088, China.
| | - Christine Bruguier
- University Center of Legal Medicine, Lausanne-Geneva (CURML), Lausanne, CH1000, Switzerland
| | - Fabrice Dedouit
- Service de Médecine Légale, Hôpital de Rangueil, Toulouse, 50032, France
| | - Silke Grabherr
- University Center of Legal Medicine, Lausanne-Geneva (CURML), Lausanne, CH1000, Switzerland
| | - Marc Augsburger
- University Center of Legal Medicine, Lausanne-Geneva (CURML), Lausanne, CH1000, Switzerland
| | - Bei-Bei Liu
- Dian Research Center for Postmortem Imaging & Angiography, Beijing, 100192, China
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14
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Coolen T, Lolli V, Sadeghi N, Rovai A, Trotta N, Taccone FS, Creteur J, Henrard S, Goffard JC, Dewitte O, Naeije G, Goldman S, De Tiège X. Early postmortem brain MRI findings in COVID-19 non-survivors. Neurology 2020; 95:e2016-e2027. [PMID: 32546654 DOI: 10.1212/wnl.0000000000010116] [Citation(s) in RCA: 171] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered to have potential neuroinvasiveness that might lead to acute brain disorders or contribute to respiratory distress in patients with coronavirus disease 2019 (COVID-19). This study investigates the occurrence of structural brain abnormalities in non-survivors of COVID-19 in a virtopsy framework. METHODS In this prospective, monocentric, case series study, consecutive patients who fulfilled the following inclusion criteria benefited from an early postmortem structural brain MRI: death <24 hours, SARS-CoV-2 detection on nasopharyngeal swab specimen, chest CT scan suggestive of COVID-19, absence of known focal brain lesion, and MRI compatibility. RESULTS Among the 62 patients who died of COVID-19 from March 31, 2020, to April 24, 2020, at our institution, 19 decedents fulfilled the inclusion criteria. Parenchymal brain abnormalities were observed in 4 decedents: subcortical microbleeds and macrobleeds (2 decedents), cortico-subcortical edematous changes evocative of posterior reversible encephalopathy syndrome (PRES; 1 decedent), and nonspecific deep white matter changes (1 decedent). Asymmetric olfactory bulbs were found in 4 other decedents without downstream olfactory tract abnormalities. No brainstem MRI signal abnormality was observed. CONCLUSIONS Postmortem brain MRI demonstrates hemorrhagic and PRES-related brain lesions in non-survivors of COVID-19. SARS-CoV-2-related olfactory impairment seems to be limited to olfactory bulbs. Brainstem MRI findings do not support a brain-related contribution to respiratory distress in COVID-19.
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Affiliation(s)
- Tim Coolen
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Valentina Lolli
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Niloufar Sadeghi
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Antonin Rovai
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Nicola Trotta
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Fabio Silvio Taccone
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Jacques Creteur
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Sophie Henrard
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Jean-Christophe Goffard
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Olivier Dewitte
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Gilles Naeije
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Serge Goldman
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier De Tiège
- From the Department of Radiology (T.C., V.L., N.S.), Department of Nuclear Medicine (A.R., N.T., S.G., X.D.T.), Intensive Care Unit (F.S.T., J.C.), Department of Internal Medicine (S.H., J.-C.G.), Department of Neurosurgery (O.D.W.), and Department of Neurology (G.N.), CUB Hôpital Erasme, and Laboratoire de Cartographie fonctionnelle du Cerveau (T.C., V.L., A.R., N.T., S.G., X.D.T.), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium.
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15
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Webb B, Manninger M, Leoni M, Widek T, Dobrovnik M, Scherr D, Stollberger R, Schwark T. T 2 and T 2∗ mapping in ex situ porcine myocardium: myocardial intravariability, temporal stability and the effects of complete coronary occlusion. Int J Legal Med 2019; 134:679-690. [PMID: 31848700 DOI: 10.1007/s00414-019-02211-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 11/13/2019] [Indexed: 11/25/2022]
Abstract
Diagnosis of ischaemia-related sudden cardiac death in the absence of microscopic and macroscopic ischaemic lesions remains a challenge for medical examiners. Medical imaging techniques increasingly provide support in post-mortem examinations by detecting and documenting internal findings prior to autopsy. Previous studies have characterised MR relaxation times to investigate post-mortem signs of myocardial infarction in forensic cohorts. In this prospective study based on an ex situ porcine heart model, we report fundamental findings related to intramyocardial variability and temporal stability of T2 as well as the effects of permanent coronary occlusion on T2 and T2∗ relaxation in post-mortem myocardium. The ex situ porcine hearts included in this study (n= 19) were examined in two groups (Ss, n= 11 and Si, n= 8). All magnetic resonance imaging (MRI) examinations were performed ex situ, at room temperature and at 3 T. In the Ss group, T2 mapping was performed on slaughterhouse porcine hearts at different post-mortem intervals (PMI) between 7 and 26 h. Regarding the intramyocardial variability, no statistically significant differences in T2 were observed between myocardial segments (p= 0.167). Assessment of temporal stability indicated a weak negative correlation (r=- 0.21) between myocardial T2 and PMI. In the Si group, animals underwent ethanol-induced complete occlusion of the left anterior descending artery. T2 and T2∗ mapping were performed within 3 h of death. Differences between the expected ischaemic and remote regions were statistically significant for T2 (p= 0.007), however not for T2∗ (p= 0.062). Our results provide important information for future assessment of the diagnostic potential of quantitative MRI in the post-mortem detection of early acute myocardial infarction.
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Affiliation(s)
- Bridgette Webb
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Graz, Austria.
- BioTechMed, Graz, Austria.
| | - Martin Manninger
- Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Marlene Leoni
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Thomas Widek
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Graz, Austria
- BioTechMed, Graz, Austria
| | - Martin Dobrovnik
- Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - Daniel Scherr
- Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria
- Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rudolf Stollberger
- BioTechMed, Graz, Austria
- Institute of Medical Engineering, Graz University of Technology, Graz, Austria
| | - Thorsten Schwark
- Ludwig Boltzmann Institute for Clinical Forensic Imaging, Graz, Austria
- Institute of Forensic Medicine, Medical University Graz, Graz, Austria
- Laboratoire National de Santé, Dudelange, Luxembourg
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16
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Imanishi T, Akeda K, Murata K, Sudo A. Effect of diminished flow in rabbit lumbar arteries on intervertebral disc matrix changes using MRI T2-mapping and histology. BMC Musculoskelet Disord 2019; 20:347. [PMID: 31351455 PMCID: PMC6661094 DOI: 10.1186/s12891-019-2721-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/15/2019] [Indexed: 12/17/2022] Open
Abstract
Background Impaired lumbar artery flow has been reported in clinical and epidemiological studies to be associated with low back pain and lumbar disc degeneration. However, it has not been experimentally demonstrated that impaired lumbar artery flow directly induces intervertebral disc (IVD) degeneration by affecting IVD matrix metabolism. The purpose of this study was to evaluate whether ligation of the lumbar artery can affect degenerative changes in the rabbit IVD. Methods New Zealand White rabbits (n = 20) were used in this study. Under general anesthesia, the third and fourth lumbar arteries were double-ligated using vascular clips. The blood flow to the L3/L4 disc (cranial disc) was reduced by ligation of the third lumbar artery and that of the L5/L6 disc (caudal disc) by ligation of the fourth lumbar artery. The blood flow to the L4/L5 disc (bilateral disc) was decreased by ligation of both the third and fourth lumbar arteries. The L2/L3 disc was used as the control. Disc height was radiographically monitored biweekly until 12 weeks after surgery. The rabbits were sacrificed at 4, 8, and 12 weeks after surgery and magnetic resonance imaging (MRI) T2-mapping, histology and immunohistochemistry were assessed. Results Lumbar artery ligation did not induce significant changes in disc height between control and ischemic discs (cranial, bilateral and caudal discs) during the 12-week experimental period. T2-values of ischemic discs had no significant trend to be lower than those of the control L2/L3 discs. Histologically, Safranin-O staining changed following ligation of corresponding IVD lumbar arteries. Histological grading scores for disc degeneration, which correlated significantly with MRI T2-values, had significant changes after the surgery. Immunohistochemical analysis showed that the ligation of lumbar arteries significantly affected a change in the percentage of HIF-1α immunoreactive cells of ischemia discs compared to that of control discs four weeks after the surgery (p < 0.05). Conclusions The MRI and histology results suggest that diminished flow in lumbar arteries induce mild changes in the extracellular matrix metabolism of rabbit IVDs. These matrix changes, however, were not progressive and differed from the degenerative disc changes seen in the process of human IVD degeneration.
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Affiliation(s)
- Takao Imanishi
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan.
| | - Koichiro Murata
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
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17
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Abstract
Postmortem imaging is increasingly used in forensic practice as good complementary tool to conventional autopsy investigations. Over the last decade, postmortem cardiac magnetic resonance (PMCMR) imaging was introduced in forensic investigations of natural deaths related to cardiovascular diseases, which represent the most common causes of death in developed countries. Postmortem CMR application has yielded interesting results in ischemic myocardium injury investigations and in visualizing other pathological findings in the heart. This review presents the actual state of postmortem imaging for cardiovascular pathologies in cases of sudden cardiac death (SCD), taking into consideration both the advantages and limitations of PMCMR application.
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18
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Shelmerdine SC, Sebire NJ, Arthurs OJ. Perinatal post mortem ultrasound (PMUS): a practical approach. Insights Imaging 2019; 10:35. [PMID: 30887398 PMCID: PMC6423182 DOI: 10.1186/s13244-019-0723-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/16/2019] [Indexed: 01/05/2023] Open
Abstract
Declining rates of consent for standard perinatal autopsy has led to a rise in interest for postmortem imaging as an alternative, non-invasive method for investigation of childhood and perinatal deaths. Whilst much interest has focussed on cross-sectional techniques such as postmortem CT (PMCT) or MRI (PMMR), other modalities including postmortem ultrasound (PMUS) have been shown to have reasonable diagnostic accuracy rates, with the added benefit of being more readily accessible and affordable. There is little published information or formal guidance available on preparation for postmortem perinatal ultrasound, views to be obtained and differentiating normal postmortem change from potential abnormalities. This article will focus on the role of perinatal postmortem ultrasound as an alternative imaging method for non-invasive autopsy, with emphasis on imaging technique, practical considerations and commonly encountered case examples.
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Affiliation(s)
- Susan C Shelmerdine
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK. .,UCL Great Ormond Street Institute of Child Health, London, UK.
| | - Neil J Sebire
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Owen J Arthurs
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
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19
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Makino Y, Arai N, Hoshioka Y, Yoshida M, Kojima M, Horikoshi T, Mukai H, Iwase H. Traumatic axonal injury revealed by postmortem magnetic resonance imaging: A case report. Leg Med (Tokyo) 2018; 36:9-16. [PMID: 30312836 DOI: 10.1016/j.legalmed.2018.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 09/03/2018] [Accepted: 09/30/2018] [Indexed: 11/26/2022]
Abstract
In forensic investigations, it is important to detect traumatic axonal injuries (TAIs) to reveal head trauma that might otherwise remain occult. These lesions are subtle and frequently ambiguous on macroscopic evaluations. We present a case of TAI revealed by pre-autopsy postmortem magnetic resonance imaging (PMMR). A man in his sixties was rendered unconscious in a motor vehicle accident. CT scans revealed traumatic mild subarachnoid hemorrhage. Two weeks after the accident he regained consciousness, but displayed an altered mental state. Seven weeks after the accident, he suddenly died in hospital. Postmortem computed tomography (PMCT) and PMMR were followed by a forensic autopsy. PMMR showed low-intensity lesions in parasagittal white matter, deep white matter, and corpus callosum on three-dimensional gradient-echo T1-weighted imaging (3D-GRE T1WI). In some of these lesions, T2∗-weighted imaging also showed low-intensity foci suggesting hemorrhagic axonal injury. The lesions were difficult to find on PMCT and macroscopic evaluation, but were visible on antemortem MRI and confirmed as TAIs on histopathology. From this case, it can be said that PMMR can detect subtle TAIs missed by PMCT and macroscopic evaluation. Hence, pre-autopsy PMMR scanning could be useful for identifying TAIs during forensic investigations.
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Affiliation(s)
- Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Nobutaka Arai
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Yumi Hoshioka
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Maiko Yoshida
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Masatoshi Kojima
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Takuro Horikoshi
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan
| | - Hiroki Mukai
- Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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20
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SyMRI of the Brain: Rapid Quantification of Relaxation Rates and Proton Density, With Synthetic MRI, Automatic Brain Segmentation, and Myelin Measurement. Invest Radiol 2018; 52:647-657. [PMID: 28257339 PMCID: PMC5596834 DOI: 10.1097/rli.0000000000000365] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Conventional magnetic resonance images are usually evaluated using the image signal contrast between tissues and not based on their absolute signal intensities. Quantification of tissue parameters, such as relaxation rates and proton density, would provide an absolute scale; however, these methods have mainly been performed in a research setting. The development of rapid quantification, with scan times in the order of 6 minutes for full head coverage, has provided the prerequisites for clinical use. The aim of this review article was to introduce a specific quantification method and synthesis of contrast-weighted images based on the acquired absolute values, and to present automatic segmentation of brain tissues and measurement of myelin based on the quantitative values, along with application of these techniques to various brain diseases. The entire technique is referred to as “SyMRI” in this review. SyMRI has shown promising results in previous studies when used for multiple sclerosis, brain metastases, Sturge-Weber syndrome, idiopathic normal pressure hydrocephalus, meningitis, and postmortem imaging.
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21
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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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22
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Keller S, Schmidt TM, Kim AC, Fischer R, Heinemann A, Adam G, Yamamura J. Postmortem MR diffusion-weighted imaging of the liver: time-behavior of the hepatic apparent diffusion coefficient in the early death interval. Int J Legal Med 2017; 132:263-268. [PMID: 28905134 DOI: 10.1007/s00414-017-1685-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of this study is to assess postmortem changes of the hepatic apparent diffusion coefficient (ADC) at multiple time points in the time interval of 16 hours postmortem in comparison to in vivo controls and to literature data. MATERIAL AND METHODS Hepatic diffusion-weighted imaging (DWI) was repeatedly performed at 1.5 Tesla (b values 50, 400, and 800 s/mm2) in 2-hourly steps within 16 hours postmortem in 19 cases (male to female 13:6, mean age 68.5 ± 12.2 years) and 5 in vivo controls. The core body temperature was measured rectally prior to every scan. Mean ADC values were calculated from regions of interest (ROIs) and compared to in vivo healthy controls and to literature data of normal liver parenchyma. Spearman rank correlation and Levenberg-Marquardt algorithm were used to assess a relationship between postmortem core body temperature and ADC values. RESULTS Mean hepatic ADC values were significantly lower in postmortem cases than in in vivo controls (52.0 ± 15.0 · 10-5 mm2/s vs. 111.0 ± 15.7 · 10-5 mm2/s, p < 0.0001). The ex vivo liver ADC correlated inversely to calculated liver temperature (-3.5 ± 0.8) · 10-5 mm2/s/°C, r = -0.44, p < 0.0001. At low calculated liver temperature (< 30 °C), the ADC described an average increase of (22 ± 10) · 10-5 mm2/s/°C. CONCLUSION Hepatic ADC values show a characteristic change in the immediate 16 hours postmortem, which is influenced by the postmortem liver temperature change. With the knowledge of characteristic postmortem liver changes, diffusion-weighted imaging could be added to conventional postmortem MRI for virtual autopsy.
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Affiliation(s)
- Sarah Keller
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
| | - Tony M Schmidt
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Catherine Kim
- The Permanente Medical Group, Department Stroke and Neurovascular Imaging, San Francisco, CA, USA
| | - Roland Fischer
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Axel Heinemann
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Butenfeld 34, 22529, Hamburg, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany
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23
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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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24
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Temperature-corrected postmortem 3-T MR quantification of histopathological early acute and chronic myocardial infarction: a feasibility study. Int J Legal Med 2017; 132:541-549. [PMID: 28612206 DOI: 10.1007/s00414-017-1614-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/18/2017] [Indexed: 10/19/2022]
Abstract
The goal of the present study was to evaluate if quantitative postmortem cardiac 3-T magnetic resonance (QPMCMR) T1 and T2 relaxation times and proton density values of histopathological early acute and chronic myocardial infarction differ to the quantitative values of non-pathologic myocardium and other histopathological age stages of myocardial infarction with regard to varying corpse temperatures. In 60 forensic corpses (25 female, 35 male), a cardiac 3-T MR quantification sequence was performed prior to autopsy and cardiac dissection. Core body temperature was assessed during MR examinations. Focal myocardial signal alterations in synthetically generated MR images were measured for their T1, T2, and proton density (PD) values. Locations of signal alteration measurements in PMCMR were targeted at heart dissection, and myocardial tissue specimens were taken for histologic examinations. Quantified signal alterations in QPMCMR were correlated to their according histologic age stage of myocardial infarction, and quantitative values were corrected for a temperature of 37 °C. In QPMCMR, 49 myocardial signal alterations were detected in 43 of 60 investigated hearts. Signal alterations were diagnosed histologically as early acute (n = 16), acute (n = 10), acute with hemorrhagic component (n = 9), subacute (n = 3), and chronic (n = 11) myocardial infarction. Statistical analysis revealed that based on their temperature-corrected quantitative T1, T2, and PD values, a significant difference between early acute, acute, and chronic myocardial infarction can be determined. It can be concluded that quantitative 3-T postmortem cardiac MR based on temperature-corrected T1, T2, and PD values may be feasible for pre-autopsy diagnosis of histopathological early acute, acute, and chronic myocardial infarction, which needs to be confirmed histologically.
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25
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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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26
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Schwendener N, Jackowski C, Persson A, Warntjes MJ, Schuster F, Riva F, Zech WD. Detection and differentiation of early acute and following age stages of myocardial infarction with quantitative post-mortem cardiac 1.5T MR. Forensic Sci Int 2016; 270:248-254. [PMID: 27836412 DOI: 10.1016/j.forsciint.2016.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 09/26/2016] [Accepted: 10/16/2016] [Indexed: 11/25/2022]
Abstract
Recently, quantitative MR sequences have started being used in post-mortem imaging. The goal of the present study was to evaluate if early acute and following age stages of myocardial infarction can be detected and discerned by quantitative 1.5T post-mortem cardiac magnetic resonance (PMCMR) based on quantitative T1, T2 and PD values. In 80 deceased individuals (25 female, 55 male), a cardiac MR quantification sequence was performed prior to cardiac dissection at autopsy in a prospective study. Focal myocardial signal alterations detected in synthetically generated MR images were MR quantified for their T1, T2 and PD values. The locations of signal alteration measurements in PMCMR were targeted at autopsy heart dissection and cardiac tissue specimens were taken for histologic examinations. Quantified signal alterations in PMCMR were correlated to their according histologic age stage of myocardial infarction. In PMCMR seventy-three focal myocardial signal alterations were detected in 49 of 80 investigated hearts. These signal alterations were diagnosed histologically as early acute (n=39), acute (n=14), subacute (n=10) and chronic (n=10) age stages of myocardial infarction. Statistical analysis revealed that based on their quantitative T1, T2 and PD values, a significant difference between all defined age groups of myocardial infarction can be determined. It can be concluded that quantitative 1.5T PMCMR quantification based on quantitative T1, T2 and PD values is feasible for characterization and differentiation of early acute and following age stages of myocardial infarction.
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Affiliation(s)
- Nicole Schwendener
- Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland
| | - Christian Jackowski
- Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland
| | - Anders Persson
- Center for Medical Image Science and Visualization, CMIV, Linköping University, SE-58183 Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marcel J Warntjes
- Center for Medical Image Science and Visualization, CMIV, Linköping University, SE-58183 Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Frederick Schuster
- Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland; Department of Diagnostic, Interventional and Pediatric Radiology, Hospital and University of Bern Inselspital, Freiburgstrasse 10, Bern CH-3010, Switzerland
| | - Fabiano Riva
- Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland
| | - Wolf-Dieter Zech
- Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland; Center for Medical Image Science and Visualization, CMIV, Linköping University, SE-58183 Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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27
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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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28
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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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29
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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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30
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Rigor mortis at the myocardium investigated by post-mortem magnetic resonance imaging. Forensic Sci Int 2015; 257:93-97. [DOI: 10.1016/j.forsciint.2015.07.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/17/2015] [Accepted: 07/24/2015] [Indexed: 11/20/2022]
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