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Staicu A, Albu C, Popa-Stanila R, Bondor C, Chiriac L, Eniu D, Goidescu I, Florian AR, Surcel M, Cruciat G, Muresan D, Rotar I. Whole-body non-forensic fetal virtopsy using postmortem magnetic resonance imaging at 7 Tesla vs classical autopsy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024. [PMID: 39376058 DOI: 10.1002/uog.29106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 10/09/2024]
Abstract
OBJECTIVE To determine the diagnostic accuracy of virtual autopsy using whole-body postmortem ultra-high field magnetic resonance imaging (MRI) at 7 Tesla (T), using a short T2-weighted imaging (T2-WI) protocol, compared with classical autopsy, for detecting structural abnormalities in small second-trimester fetuses. METHODS Thirty consecutive fetuses at 13-19 weeks' gestation (weight, 17-364 g) were included following spontaneous pregnancy loss or termination of pregnancy. After fixation in 10% formaldehyde solution (48 h to 1 week), all fetuses were scanned using a two-dimensional turbo high-resolution T2-WI protocol with multislice relaxation time, followed by an invasive autopsy. The diagnostic accuracy of virtual autopsy vs classical autopsy was calculated for 990 anatomical structures (30 fetuses × 33 items). Sensitivity, specificity, positive and negative predictive values and Cohen's κ coefficient of agreement, with their 95% CIs, as well as the McNemar test, were used to evaluate the accuracy and agreement of the two diagnostic methods. Analysis was stratified by anatomical segment (nervous, pulmonary, cardiovascular, digestive, renal, facial and skeletal) and across three gestational-age intervals (13-14, 15-16 and 17-19 weeks). RESULTS Considering classical autopsy as the gold standard, virtual autopsy had a sensitivity of 92.04% (95% CI, 85.42-96.29%) and a specificity of 97.87% (95% CI, 94.64-99.42%), with a positive predictive value of 96.30% (95% CI, 90.78-98.56%) and a negative predictive value of 95.34% (95% CI, 91.61-97.45%), achieving a diagnostic accuracy of 95.68% (95% CI, 92.73-97.68%) for detecting structural abnormalities in second-trimester fetuses. Cohen's κ for virtual vs classical autopsy was 0.907. The diagnostic ability of virtual autopsy at 7 T for malformed fetuses was superior to that of classical autopsy for analyzing the nervous system in small fetuses with pronounced autolysis, equivalent to that of classical autopsy when analyzing pulmonary, cardiovascular and renal systems and inferior when evaluating the fetal intestines. The sensitivity of virtual autopsy at 7 T for describing structural abnormalities increased with gestational age. CONCLUSION Virtual fetal autopsy using 7-T MRI and a turbo high-resolution T2-WI protocol with multislice relaxation time is a feasible postmortem diagnostic tool for the identification of fetal structural anomalies. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A Staicu
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Albu
- Department of Pathology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Centre of Advanced Research Studies, Emergency County Hospital, IMOGEN, Cluj-Napoca, Romania
| | - R Popa-Stanila
- Centre of Advanced Research Studies, Emergency County Hospital, IMOGEN, Cluj-Napoca, Romania
- Department of Radiology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Bondor
- Department of Medical Informatics and Biostatistics, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - L Chiriac
- Department of Medical Biophysics, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
- National Magnetic Resonance Centre, Babeș Bolyai University, Cluj-Napoca, Romania
- Faculty of Physics, Babeș Bolyai University, Cluj-Napoca, Romania
| | - D Eniu
- Department of Medical Biophysics, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - I Goidescu
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A R Florian
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M Surcel
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - G Cruciat
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D Muresan
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - I Rotar
- Mother and Child Department, 1st Clinic of Obstetrics and Gynaecology, 'Iuliu Haţieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Nagai A, Kobayashi T, Kurosawa K, Niizuma K, Endo H. A Case of Hanging with Limited Specific Postmortem Brain Imaging. NMC Case Rep J 2024; 11:249-255. [PMID: 39295788 PMCID: PMC11407918 DOI: 10.2176/jns-nmc.2024-0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 06/20/2024] [Indexed: 09/21/2024] Open
Abstract
In Japan, the number of autopsies has steadily decreased. Therefore, postmortem imaging methods have positioned as valuable supplemental or complementary tools in autopsy procedures. We clinicians are increasingly faced with the need to infer cause of death from postmortem imaging findings. We report computed tomography (CT) and magnetic resonance imaging (MRI) findings of a 41-year-old man who committed suicide by hanging. CT revealed fractures of the left superior horn of the thyroid cartilage. Head MRI showed high signal intensity in the basal ganglia on the T1-weighted image and high-intensity rims along the cerebral cortex on the diffusion-weighted image; however, these were considered normal postmortem changes. There were no significant findings in the heart, major blood vessels, or abdominal organs. The contents of the stomach were minimal, and no tablets or other evidence suggestive of drug overdose were identified. Traumatic changes were not observed. Based on the scene and his circumstances, it was speculated that he died by hanging and an autopsy was not performed. This case highlights the importance of understanding normal postmortem brain imaging changes to estimate the true cause of death.
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Affiliation(s)
- Arata Nagai
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tomoya Kobayashi
- Department of Clinical Imaging, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kyuzo Kurosawa
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Kurosawa Neurosurgical and Imaging Clinic, Shiogama, Miyagi, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Berger C, Bauer M, Wittig H, Gerlach K, Scheurer E, Lenz C. Investigation of post mortem brain, rectal and forehead temperature relations. J Therm Biol 2023; 115:103615. [PMID: 37390676 DOI: 10.1016/j.jtherbio.2023.103615] [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: 10/25/2022] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023]
Abstract
It is well known that magnetic resonance (MR) imaging is temperature sensitive, which is highly relevant for post mortem examinations. Therefore, the determination of the exact temperature of the investigated body site, e.g. the brain, is crucial. However, direct temperature measurements are invasive and inconvenient. Thus, in view of post mortem MR imaging of the brain, this study aims at investigating the relation between the brain and the forehead temperature for modelling the brain temperature based on the non-invasive forehead temperature. In addition, the brain temperature will be compared to the rectal temperature. Brain temperature profiles measured in the longitudinal fissure between the brain hemispheres, as well as rectal and forehead temperature profiles of 16 deceased were acquired continuously. Linear mixed, linear, quadratic and cubic models were fitted to the relation between the longitudinal fissure and the forehead and between the longitudinal fissure and the rectal temperature, respectively. Highest adjusted R2 values were found between the longitudinal fissure and the forehead temperature, as well as between the longitudinal fissure and the rectal temperature using a linear mixed model including the sex, environmental temperature and humidity as fixed effects. The results indicate that the forehead, as well as the rectal temperature, can be used to model the brain temperature measured in the longitudinal fissure. Comparable fit results were observed for the longitudinal fissure-forehead temperature relation and for the longitudinal fissure-rectal temperature relation. Combined with the fact that the forehead temperature overcomes the problem of measurement invasiveness, the results suggest using the forehead temperature for modelling the brain temperature in the longitudinal fissure.
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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
| | - Holger Wittig
- Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland
| | - Kathrin Gerlach
- 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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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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Rahmani V, Peltonen J, Amarilla SP, Spillmann T, Ruohoniemi M. Cholangiopancreatography in cats: a post-mortem comparison of MRI with fluoroscopy, corrosion casting and histopathology. Vet Radiol Ultrasound 2023. [PMID: 37133979 DOI: 10.1111/vru.13240] [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: 06/25/2022] [Revised: 03/25/2023] [Accepted: 03/25/2023] [Indexed: 05/04/2023] Open
Abstract
In human medicine, magnetic resonance cholangiopancreatography (MRCP) is a valuable diagnostic tool for hepatobiliary and pancreatic diseases. In veterinary medicine, however, data evaluating the diagnostic value of MRCP are limited. The primary objectives of this prospective, observational, analytical investigation were to assess whether MRCP reliably visualizes the biliary tract and pancreatic ducts in cats without and with related disorders, and whether MRCP images and measurements of the ducts agree with those of fluoroscopic retrograde cholangiopancreatography (FRCP), corrosion casting and histopathology. A secondary objective was to provide MRCP reference diameters for bile ducts, GB, and pancreatic ducts. Donated bodies of 12 euthanized adult cats underwent MRCP, FRCP, and autopsy with corrosion casting of the biliary tract and pancreatic ducts using vinyl polysiloxane. Diameters of the biliary ducts, gallbladder (GB), and pancreatic ducts were measured using MRCP, FRCP, corrosion casts and histopathologic slides. There was an agreement between MRCP and FRCP in measuring diameters of the GB body, GB neck, cystic duct, and common bile duct (CBD) at papilla. Strong positive correlations existed between MRCP and corrosion casting for measuring GB body and neck, cystic duct, and CBD at the extrahepatic ducts' junction. In contrast to the reference methods, post-mortem MRCP did not visualize right and left extrahepatic ducts, and pancreatic ducts in most cats. Based on this study, MRCP with 1.5 Tesla can be regarded as a contributory method to improve the assessment of feline biliary tract and pancreatic ducts when their diameter is >1 mm.
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Affiliation(s)
- Vahideh Rahmani
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Juha Peltonen
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Shyrley Paola Amarilla
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathological Sciences, Faculty of Veterinary Sciences, National University of Asuncion, San Lorenzo, Paraguay
| | - Thomas Spillmann
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Mirja Ruohoniemi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Okawa R, Yasui G, Mihara B, Hayashi N. Optimization of the fluid-attenuated inversion recovery (FLAIR) imaging for use in autopsy imaging of the brain region using synthetic MRI. Technol Health Care 2023; 31:661-674. [PMID: 36093648 DOI: 10.3233/thc-220230] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND The failure of cerebrospinal fluid (CSF) signal suppression in postmortem fluid-attenuated inversion recovery (FLAIR) of the brain is a problem. OBJECTIVE The present study was to clarify the relationship between the temperature of deceased persons and CSF T1, and to optimize the postmortem brain FLAIR imaging method using synthetic MRI. METHODS Forehead temperature was measured in 15 deceased persons. Next, synthetic MRI of the brain was performed, the CSF T1 was measured, and the optimal TI was calculated. Two types of FLAIR images were obtained with the clinical and optimal TI. The relationship between forehead temperature and the CSF T1 and optimal TI was evaluated. The optimized FLAIR images were physically and visually evaluated. RESULTS The CSF T1 and optimal TI were strongly correlated with forehead temperature. Comparing the average SNR and CNR ratios and visual evaluation scores of the two FLAIR images, those captured with the optimal TI showed statistically lower SNR, higher CNR, and higher visual evaluation scores (p< 0.01). CONCLUSIONS Synthetic MRI enables the quantification of the CSF T1 resulting from postmortem temperature decreases and calculation of the optimal TI, which could aid in improving the failure of CSF signal suppression and in optimizing postmortem brain FLAIR imaging.
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Affiliation(s)
- Ryuya Okawa
- Department of Diagnostic Imaging, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki, Japan
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | - Go Yasui
- Department of Diagnostic Imaging, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki, Japan
| | - Ban Mihara
- Department of Neurology, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki, Japan
| | - Norio Hayashi
- Department of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan
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Roles of radiological technologists at Tsukuba Medical Examiner's Office equipped with a computed tomography system dedicated for the examination of corpses. FORENSIC IMAGING 2022. [DOI: 10.1016/j.fri.2022.200508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Gupta N, Gupta A, Kumar A, Kabra M, Sharma R, Kumar Gupta A, Jana M. Post-mortem MRI in stillbirth: normal imaging appearances. Eur J Radiol 2022; 148:110166. [DOI: 10.1016/j.ejrad.2022.110166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/22/2021] [Accepted: 01/15/2022] [Indexed: 11/25/2022]
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Shchegolev AI, Tumanova UN, Savva OV. [Postmortem assessment of cerebral edema]. Arkh Patol 2022; 84:74-80. [PMID: 36469722 DOI: 10.17116/patol20228406174] [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] [Indexed: 06/17/2023]
Abstract
An analysis of literature data on the methods of post-mortem assessment of cerebral edema is presented. Based on the mechanisms of development, two main types of cerebral edema are distinguished: cytotoxic (intracellular) and vasogenic (extracellular). To determine cerebral edema, a number of methods are used, both direct and indirect, invasive and non-invasive assessment. Direct methods for assessing cerebral edema are based on determining the amount of water in its tissue. Indirect methods include morphological and radiation studies. Traditionally, the most evidence-based criteria for the diagnosis of cerebral edema are macroscopic and microscopic changes determined at autopsy. Methods are also indicated for determining the content of water in brain tissue by comparing the mass of wet and dry brain, as well as estimating the specific density of brain tissue.
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Affiliation(s)
- A I Shchegolev
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia
| | - U N Tumanova
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia
| | - O V Savva
- National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow, Russia
- Bureau of Forensic Medicine named after D.I. Mastbaum, Ryazan, Russia
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Deininger-Czermak E, Euler A, Franckenberg S, Finkenstaedt T, Villefort C, Gascho D, Guggenberger R. Evaluation of ultrashort echo-time (UTE) and fast-field-echo (FRACTURE) sequences for skull bone visualization and fracture detection - A postmortem study. J Neuroradiol 2021; 49:237-243. [PMID: 34758365 DOI: 10.1016/j.neurad.2021.11.001] [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: 05/22/2021] [Revised: 10/11/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE CT is considered the modality of choice in the assessment of the skull due to the fast and accurate depiction of bone structures. Nevertheless, MRI has evolved into a possible alternative due to optimal soft tissue contrast and recent advances with the ability to visualize tissues with shortest T2 times, such as osseous structures. In this study we compare skull bone visualization and fracture detection across two MRI sequences to CT as reference standard. MATERIAL AND METHODS Twenty subjects underwent CT and MRI with less than 72 h between examination. The MRI protocol included a 2D ultrashort echo time (UTE) and a 3D multi-echo in-phase fast-field-echo (FRACTURE) sequence. Independent raters evaluated qualitative characteristics and fracture detectability in different skull subregions (skull vault, skull base and viscerocranium). Interrater and intermodality agreement was evaluated by calculating intraclass coefficients (ICC). RESULTS FRACTURE ICC indicated a good agreement in all subregions (ICC = 0.83 - 0.88), whereas UTE had excellent results calculated in the skull vault and viscerocranium (ICC = 0.91 - 0.94). At the skull vault, both MRI sequences received an overall good rating (UTE: 2.63 ± 0.42 FRACTURE. 2.81 ± 0.32). Fracture detection using MRI sequences for the skull vault, was highest compared to other subregions. CONCLUSIONS Both MRI sequences may provide an alternative e.g. for surgical planning or follow up exams of the osseous neurocranium; although, at the skull base and viscerocranium bone visualization with MRI bone imaging sequences perform inferior to CT standard imaging.
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Affiliation(s)
- Eva Deininger-Czermak
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Andre Euler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Sabine Franckenberg
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Tim Finkenstaedt
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Dominic Gascho
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
| | - Roman Guggenberger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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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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Zhang S, Yuan X, Peng Z, Jian N, Tian M, Feng X, Lin X, Wang X. Normal fetal development of the cervical, thoracic, and lumbar spine: A postmortem study based on magnetic resonance imaging. Prenat Diagn 2021; 41:989-997. [PMID: 34128545 DOI: 10.1002/pd.5984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/19/2021] [Accepted: 05/30/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. This study aims to characterize normal spinal growth in human fetuses during the second and third trimesters. METHODS Postmortem 3.0 T magnetic resonance imaging (MRI) was performed on 55 fetuses at 17-42 gestational weeks by using three-dimensional T2-weighted sequences. Morphological changes and quantitative measurements of the fetal spine were assessed. The correlation between centrum ossification center volume (COCV) and gestational age was investigated. RESULTS The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age (p < 0.05). No gender differences were found in the volumetric development of the cervical, thoracic, and lumbar centrum ossification centers (COCs). The average volumetric growth rate per COC was larger in the lumbar spine than in the cervical and thoracic spine. The L1-L5 COCVs also showed a linear positive relationship with gestational age. CONSULTS Postmortem 3.0 T MRI clearly demonstrated spinal changes in external contour and internal structure with gestational age. These findings expand our understanding of the early growth pattern of the human spine and could be further used to assess the developmental conditions of the fetal spine.
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Affiliation(s)
- Shuai Zhang
- School of Medicine, Shandong First Medical University, Jinan, Shandong, China
| | - Xianshun Yuan
- Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, Shandong, China
| | - Zhao Peng
- Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, Shandong, China
| | - Nan Jian
- CT Department, Heze Municipal Hospital, Heze, Shandong, China
| | - Mimi Tian
- Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiang Feng
- MR Scientific Marketing, Diagnosis Imaging, Siemens Healthcare Ltd, Chaoyang, Beijing, China
| | - Xiangtao Lin
- Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ximing Wang
- Shandong Provincial Hospital Affliated to Shandong First Medical University, Jinan, Shandong, China
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Alrayashi R, Braun RD, Muca A, Kühl A, Hali M, Holt AG. Postmortem neuroimaging: Temporal and spatial sensitivity of manganese-enhanced magnetic resonance imaging (MEMRI) and impact of Mn 2+ uptake. Hear Res 2021; 407:108276. [PMID: 34107410 DOI: 10.1016/j.heares.2021.108276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/20/2021] [Accepted: 05/08/2021] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging data collection and analysis have been challenges in the field of auditory neuroscience. Recent studies have addressed these concerns by using manganese-enhanced magnetic resonance imaging (MEMRI). Basic challenges for in vivo application of MEMRI in rodents includes how to set inclusion criteria for adequate Mn2+ uptake and whether valid data can be collected from brains postmortem. Since brain Mn2+ uptake is complete within 2-4 h and clearance can take 2-4 weeks, one assumption has been that Mn2+-enhanced R1 values continue to reliably reflect the degree of Mn2+-uptake for some indeterminate time after death. To address these issues, the impact of death on R1 values was determined in rats administered Mn2+ and rats that were not. Images of auditory nuclei were collected at fixed intervals from rats before and after death for up to 10 h postmortem. By taking a ratio of pituitary and muscle T1-W intensities (P/M), a reliable quantitative method for assessing adequate brain Mn2+ uptake was created and suggest that P/M ratios should be adopted to objectively measure the quality of the Mn2+ injection. Postmortem R1 values decreased in all brain regions in both the After Mn2+ and No Mn2+ groups. However, the time-course of postmortem changes in R1 was dependent on brain region and degree of Mn2+ uptake. Thus, postmortem R1 values not only differ after death, but vary with time and across brain regions. Postmortem R1 values in unfixed brain tissue, including the auditory nuclei, should be interpreted with caution.
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Affiliation(s)
- Rasheed Alrayashi
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Rod D Braun
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Antonela Muca
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - André Kühl
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mirabela Hali
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Avril Genene Holt
- Department of Ophthalmology, Visual, and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA; John D. Dingell VAMC, Detroit, MI, USA.
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15
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Harty MP, Gould SW, Harcke HT. Navigating the perils and pitfalls of pediatric forensic postmortem imaging in the United States. Pediatr Radiol 2021; 51:1051-1060. [PMID: 33999245 DOI: 10.1007/s00247-020-04833-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 05/28/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023]
Abstract
Postmortem CT is widely used in the general adult and military populations. It is used extensively in pediatric death investigations in Europe and Asia, but distinctive challenges are encountered when launching a postmortem imaging program in the United States. We describe the issues we have encountered specific to establishing a pediatric postmortem imaging service in this country and propose potential solutions.
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Affiliation(s)
- Mary P Harty
- Department of Medical Imaging, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA.
| | - Sharon W Gould
- Department of Medical Imaging, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA
| | - Howard T Harcke
- Department of Medical Imaging, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA
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16
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Bobić-Rasonja M, Pogledić I, Mitter C, Štajduhar A, Milković-Periša M, Trnski S, Bettelheim D, Hainfellner JA, Judaš M, Prayer D, Jovanov-Milošević N. Developmental Differences Between the Limbic and Neocortical Telencephalic Wall: An Intrasubject Slice-Matched 3 T MRI-Histological Correlative Study in Humans. Cereb Cortex 2021; 31:3536-3550. [PMID: 33704445 DOI: 10.1093/cercor/bhab030] [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: 12/05/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
The purpose of the study was to investigate the interrelation of the signal intensities and thicknesses of the transient developmental zones in the cingulate and neocortical telencephalic wall, using T2-weighted 3 T-magnetic resonance imaging (MRI) and histological scans from the same brain hemisphere. The study encompassed 24 postmortem fetal brains (15-35 postconceptional weeks, PCW). The measurements were performed using Fiji and NDP.view2. We found that T2w MR signal-intensity curves show a specific regional and developmental stage profile already at 15 PCW. The MRI-histological correlation reveals that the subventricular-intermediate zone (SVZ-IZ) contributes the most to the regional differences in the MRI-profile and zone thicknesses, growing by a factor of 2.01 in the cingulate, and 1.78 in the neocortical wall. The interrelations of zone or wall thicknesses, obtained by both methods, disclose a different rate and extent of shrinkage per region (highest in neocortical subplate and SVZ-IZ) and stage (highest in the early second half of fetal development), distorting the zones' proportion in histological sections. This intrasubject, slice-matched, 3 T correlative MRI-histological study provides important information about regional development of the cortical wall, critical for the design of MRI criteria for prenatal brain monitoring and early detection of cortical or other brain pathologies in human fetuses.
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Affiliation(s)
- Mihaela Bobić-Rasonja
- Croatian Institute for Brain Research, School of Medicine University of Zagreb, 10000 Zagreb, Croatia.,Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivana Pogledić
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Mitter
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Andrija Štajduhar
- Croatian Institute for Brain Research, School of Medicine University of Zagreb, 10000 Zagreb, Croatia.,Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marija Milković-Periša
- University Hospital Centre Zagreb, Department of Pathology and Cytology, 10000 Zagreb, Croatia
| | - Sara Trnski
- Croatian Institute for Brain Research, School of Medicine University of Zagreb, 10000 Zagreb, Croatia
| | - Dieter Bettelheim
- Division of Obstetrics and Feto-Maternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes A Hainfellner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Miloš Judaš
- Croatian Institute for Brain Research, School of Medicine University of Zagreb, 10000 Zagreb, Croatia
| | - Daniela Prayer
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
| | - Nataša Jovanov-Milošević
- Croatian Institute for Brain Research, School of Medicine University of Zagreb, 10000 Zagreb, Croatia.,Department of Biology, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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17
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Wolosker MB, Diamante Leiderman DB, Estevan FA, Wolosker N, Zerati AE, Amaro E. Comparative Analysis of Artery Anatomy Evaluated by Postmortem Tomography, CT Angiography, and Postmortem and Predeath CT Scans. Ann Vasc Surg 2020; 72:124-137. [PMID: 32949733 DOI: 10.1016/j.avsg.2020.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/23/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND To date, no study has been performed analyzing changes in the vascular system comparing paired examinations of patients alive and after death with the use of cardiopulmonary bypass and computed tomography (CT) angiography. MATERIALS AND METHODS The aim of this study was to analyze in a large series (38 patients) the aorta and its branches by CT (without contrast) and CT angiography of patients still alive and after death comparing their diameters and length variations. RESULTS The variation between in vivo tomography and virtopsy methods was greater in the evaluation of distances between vascular segments than in the diameters; less than 30% of the distances evaluated in the entire study had acceptable variation between methods, regardless of the use of contrast scans. We observed better repeatability rates in the comparison between in vivo and postmortem contrast-enhanced examinations. Comparing the examinations of the still alive individuals with the contrast-enhanced tomography after death, we observed a higher concordance rate. The best variations between the methods were observed in the evaluation of the diameters in the contrast-enhanced examination of the ascending aorta, aortic arch, thoracic aorta, and thoracoabdominal transition. CONCLUSIONS The measurements obtained in postmortem angiography images partially reflect the vascular anatomy of the main branches in the thoracoabdominal region in vivo. However, postmortem CT without contrast was not performed in the same comparison. We believe that adjustments to the contrast injection technique may eventually improve these results.
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Affiliation(s)
| | | | | | - Nelson Wolosker
- University of São Paulo, Faculty of Medicine, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Edson Amaro
- University of São Paulo, Faculty of Medicine, São Paulo, Brazil; Hospital Israelita Albert Einstein, São Paulo, Brazil
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18
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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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19
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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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20
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Yamashiro A, Kobayashi M, Saito T. Cerebrospinal fluid T1 value phantom reproduction at scan room temperature. J Appl Clin Med Phys 2019; 20:166-175. [PMID: 31179645 PMCID: PMC6612700 DOI: 10.1002/acm2.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 01/05/2023] Open
Abstract
The T1 value of pure water, which is often used as a phantom to simulate cerebrospinal fluid, is significantly different from that of in-vivo cerebrospinal fluid. The purpose of this study was to develop a phantom with a T1 value equivalent to that of in-vivo cerebrospinal fluid under examination room temperature (23°C-25°C). In this study, 1.5 and 3.0 T magnetic resonance imaging scanners were used. We examined the signal intensity change in relation to pure water temperature, the T1 values of acetone-diluted solutions (0-100 v/v%, in 10 steps), and the correlation coefficients obtained from volunteers and the prepared phantoms. The T1 value was close to the value reported in the literature for cerebrospinal fluid when the acetone-diluted solution was 70 v/v% or higher at scan room temperature. The value at that time was 3532.81-4704.57 ms at 1.5 T and it ranged from 4052.41 to 5701.61 ms at 3.0 T. The highest correlation with the values obtained from the volunteers was r = 0.993 with pure acetone at 1.5 T and r = 0.991 with acetone 90 v/v% at 3.0 T. The relative error of the best phantom-volunteer match was 32.61 (%) ± 6.71 at 1.5 T and 46.67 (%) ± 4.31 at 3.0 T. The T1 value measured by the null point method did not detect a significant difference between in vivo CSF and acetone 100 v/v% at 1.5 T and acetone 90 v/v% at 3.0 T. The T1 value of cerebrospinal fluid in the living body at scan room temperature was reproduced with acetone. The optimum concentration of acetone for cerebrospinal-fluid reproduction was pure acetone at 1.5 T and 90 v/v% at 3.0 T.
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Affiliation(s)
- Akihiro Yamashiro
- Department of Radiology, Nagano Red Cross Hospital, Nagano-City, Nagano-ken, Japan
| | - Masato Kobayashi
- Department of Radiology, Shinano Town Shin-Etsu Hospital, Kamiminochi-gun, Nagano-ken, Japan
| | - Takaaki Saito
- Department of Radiology, Iiyama Red Cross Hospital, Iiyama-City, Nagano-ken, Japan
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21
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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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22
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Shelmerdine SC, Hutchinson JC, Al-Sarraj S, Cary N, Dawson T, Du Plessis D, Ince PG, McLaughlin S, Palm L, Smith C, Stoodley N, van Rijn R, Arthurs OJ, Jacques TS. British Neuropathological Society and International Society of Forensic Radiology and Imaging expert consensus statement for post mortem
neurological imaging. Neuropathol Appl Neurobiol 2018. [DOI: 10.1111/nan.12482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. C. Shelmerdine
- Great Ormond Street Hospital for Children; NHS Foundation Trust; London UK
- Great Ormond; Street Institute of Child Health; UCL; London UK
| | - J. C. Hutchinson
- Great Ormond Street Hospital for Children; NHS Foundation Trust; London UK
- Great Ormond; Street Institute of Child Health; UCL; London UK
| | - S. Al-Sarraj
- Department of Clinical Neuropathology; Kings College Hospital; London UK
| | - N. Cary
- Forensic Pathology Services; Wantage Oxfordshire UK
| | - T. Dawson
- Department of Neuropathology; Lancashire Teaching Hospitals NHS trust; Preston UK
| | - D. Du Plessis
- Department of Neuropathology; Salford Royal Hospital; Greater Manchester UK
| | - P. G. Ince
- Sheffield Institute for Translational Neuroscience; Sheffield University; Sheffield UK
| | - S. McLaughlin
- Edinburgh Forensic Radiology and Anthropology Imaging Centre; Royal Infirmary of Edinburgh; Edinburgh UK
| | - L. Palm
- Great Ormond Street Hospital for Children; NHS Foundation Trust; London UK
| | - C. Smith
- Academic Department of Neuropathology; Centre for Clinical Brain Sciences; University of Edinburgh; Edinburgh UK
| | - N. Stoodley
- Department of Paediatric Neuroradiology; Frenchay Hospital; Bristol UK
| | - R. van Rijn
- Department of Radiology; Academic Medical Center; Emma Children's Hospital; Amsterdam The Netherlands
| | - O. J. Arthurs
- Great Ormond Street Hospital for Children; NHS Foundation Trust; London UK
- Great Ormond; Street Institute of Child Health; UCL; London UK
| | - T. S. Jacques
- Great Ormond Street Hospital for Children; NHS Foundation Trust; London UK
- Great Ormond; Street Institute of Child Health; UCL; London UK
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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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Arribart M, Ognard J, Guintard C, Domergue F, Hassani S, Ben Salem D, Jung JL. Magnetic Resonance Imaging Study of Adipose Tissues in the Head of a Common Dolphin (Delphinus delphis): Structure Identification and Influence of a Freezing-Thawing Cycle. Anat Histol Embryol 2016; 46:204-212. [PMID: 27990670 DOI: 10.1111/ahe.12258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/11/2016] [Indexed: 11/28/2022]
Abstract
Magnetic resonance imaging (MRI) was used to scan the head of a common dolphin (Delphinus delphis) in order to visualize the different adipose tissues involved in echolocation functioning and to precisely delineate their anatomical topology. MRI scans were performed on the head taken from a freshly stranded carcass and repeated after a 2-week freezing time followed by thawing. The main fatty organs of the head, that is the melon, the mandibula bulba, the bursae cantantes, and their different connections with surrounding tissues were identified and labelled. The nasal sacs, other organs of echolocation, were also identified and labelled thanks to different MRI acquisitions. The shape, the location, the type of MRI signal of each organ and of their different connections were successfully analysed on all images, and then, the images of the head fresh or after thawing were compared. No impacts of the freezing/thawing cycle on the fatty tissues of the head were identified. Different parts were distinguished in the melon on the basis of the MRI signal emitted, corresponding most likely to the internal and external melon already identified by other analytical approaches, and linked to differences in lipid composition. MRI is shown here to be a useful tool to study the functional anatomy of the organs responsible for echolocation in odontocetes, with a particularly high level of precision.
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Affiliation(s)
- M Arribart
- Service d'anatomie comparée, Ecole Nationale Vétérinaire ONIRIS, 102 Route de Gachet, 44300, Nantes, France
| | - J Ognard
- Service d'Imagerie Forensique, LaTIM - INSERM UMR 1101, Université de Bretagne Occidentale, CHRU Brest, Boulevard Tanguy Prigent, 29609, Brest Cedex, France
| | - C Guintard
- Service d'anatomie comparée, Ecole Nationale Vétérinaire ONIRIS, 102 Route de Gachet, 44300, Nantes, France
| | - F Domergue
- Laboratoire de Biogenèse Membranaire, UMR 5200, Université de Bordeaux, 71 Avenue Edouard Bourlaux, 33883, Villenave d'Ornon Cédex, France
| | - S Hassani
- Laboratoire d'étude des mammifères marins - Océanopolis, Port de Plaisance du Moulin Blanc, 29200, Brest, France
| | - D Ben Salem
- Service d'Imagerie Forensique, LaTIM - INSERM UMR 1101, Université de Bretagne Occidentale, CHRU Brest, Boulevard Tanguy Prigent, 29609, Brest Cedex, France
| | - J-L Jung
- Laboratoire BioGeMME, Université de Bretagne Occidentale et Université Bretagne Loire - UFR Sciences et Techniques, 6 ave Le Gorgeu, 29200, Brest, France
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Whole brain analysis of postmortem density changes of grey and white matter on computed tomography by statistical parametric mapping. Eur Radiol 2016; 27:2317-2325. [DOI: 10.1007/s00330-016-4633-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/17/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
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26
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Post-mortem CT and MR brain imaging of putrefied corpses. Int J Legal Med 2016; 130:1061-1068. [DOI: 10.1007/s00414-016-1385-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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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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Augustinack JC, van der Kouwe AJW. Postmortem imaging and neuropathologic correlations. HANDBOOK OF CLINICAL NEUROLOGY 2016; 136:1321-39. [PMID: 27430472 DOI: 10.1016/b978-0-444-53486-6.00069-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Postmortem imaging refers to scanning autopsy specimens using magnetic resonance imaging (MRI) or optical imaging. This chapter summarizes postmortem imaging and its usefulness in brain mapping. Standard in vivo MRI has limited resolution due to time constraints and does not deliver cortical boundaries (e.g., Brodmann areas). Postmortem imaging offers a means to obtain ultra-high-resolution images with appropriate contrast for delineating cortical regions. Postmortem imaging provides the ability to validate MRI properties against histologic stained sections. This approach has enabled probabilistic mapping that is based on ex vivo MRI contrast, validated to histology, and subsequently mapped on to an in vivo model. This chapter emphasizes structural imaging, which can be validated with histologic assessment. Postmortem imaging has been applied to neuropathologic studies as well. This chapter includes many ex vivo studies, but focuses on studies of the medial temporal lobe, often involved in neurologic disease. New research using optical imaging is also highlighted.
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Affiliation(s)
- Jean C Augustinack
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
| | - André J W van der Kouwe
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
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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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Offiah CE, Dean J. Post-mortem CT and MRI: appropriate post-mortem imaging appearances and changes related to cardiopulmonary resuscitation. Br J Radiol 2015; 89:20150851. [PMID: 26562099 DOI: 10.1259/bjr.20150851] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Post-mortem cross-sectional imaging in the form of CT and, less frequently, MRI is an emerging facility in the evaluation of cause-of-death and human identification for the coronial service as well as in assisting the forensic investigation of suspicious deaths and homicide. There are marked differences between the radiological evaluation and interpretation of the CT and MRI features of the live patient (i.e. antemortem imaging) and the evaluation and interpretation of post-mortem CT and MRI appearances. In addition to the absence of frequently utilized tissue enhancement following intravenous contrast administration in antemortem imaging, there are a number of variable changes which occur in the tissues and organs of the body as a normal process following death, some of which are, in addition, affected significantly by environmental factors. Many patients and victims will also have undergone aggressive attempts at cardiopulmonary resuscitation in the perimortem period which will also significantly alter post-mortem CT and MRI appearances. It is paramount that the radiologist and pathologist engaged in the interpretation of such post-mortem imaging are familiar with the appropriate non-pathological imaging changes germane to death, the post-mortem interval and cardiopulmonary resuscitation in order to avoid erroneously attributing such changes to trauma or pathology. Some of the more frequently encountered radiological imaging considerations of this nature will be reviewed.
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Affiliation(s)
- Curtis E Offiah
- Department of Radiology and Imaging, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Jonathan Dean
- Department of Radiology and Imaging, Royal London Hospital, Barts Health NHS Trust, London, UK
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Montaldo P, Chaban B, Lally PJ, Sebire NJ, Taylor AM, Thayyil S. Quantification of ante-mortem hypoxic ischemic brain injury by post-mortem cerebral magnetic resonance imaging in neonatal encephalopathy. Eur J Paediatr Neurol 2015; 19:665-71. [PMID: 26235647 DOI: 10.1016/j.ejpn.2015.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 06/22/2015] [Accepted: 07/08/2015] [Indexed: 11/17/2022]
Abstract
UNLABELLED Post-mortem (PM) magnetic resonance imaging (MRI) is increasingly used as an alternative to conventional autopsy in babies dying from neonatal encephalopathy. However, the confounding effect of post-mortem changes on the detection of ante-mortem ischemic injury is unclear. We examined whether quantitative MR measurements can accurately distinguish ante-mortem ischemic brain injury from artifacts using post-mortem MRI. METHODS We compared PM brain MRI (1.5 T Siemens, Avanto) in 7 infants who died with neonatal encephalopathy (NE) of presumed hypoxic-ischemic origin with 7 newborn infants who had sudden unexplained neonatal death (SUND controls) without evidence of hypoxic-ischemic brain injury at autopsy. We measured apparent diffusion coefficients (ADCs), T1-weighted signal intensity ratios (SIRs) compared to vitreous humor and T2 relaxation times from 19 predefined brain areas typically involved in neonatal encephalopathy. RESULTS There were no differences in mean ADC values, SIRs on T1-weighted images or T2 relaxation times in any of the 19 predefined brain areas between NE and SUND infants. All MRI images showed loss of cortical gray/white matter differentiation, loss of the normal high signal intensity (SI) in the posterior limb of the internal capsule on T1-weighted images, and high white matter SI on T2-weighted images. CONCLUSION Normal post-mortem changes may be easily mistaken for ante-mortem ischemic injury, and current PM MRI quantitative assessment cannot reliably distinguish these. These findings may have important implications for appropriate interpretation of PM imaging findings, especially in medico-legal practice.
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Affiliation(s)
- Paolo Montaldo
- Centre for Perinatal Neuroscience, Imperial College London, Du Cane Road, London W12 0HS, United Kingdom.
| | - Badr Chaban
- Centre for Perinatal Neuroscience, Imperial College London, Du Cane Road, London W12 0HS, United Kingdom
| | - Peter J Lally
- Centre for Perinatal Neuroscience, Imperial College London, Du Cane Road, London W12 0HS, United Kingdom
| | - Neil J Sebire
- Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1 3JH, United Kingdom
| | - Andrew M Taylor
- Centre for Cardiovascular Imaging, Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, United Kingdom
| | - Sudhin Thayyil
- Centre for Perinatal Neuroscience, Imperial College London, Du Cane Road, London W12 0HS, United Kingdom
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Deep Into the Fibers! Postmortem Diffusion Tensor Imaging in Forensic Radiology. Am J Forensic Med Pathol 2015; 36:153-61. [DOI: 10.1097/paf.0000000000000177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ishida M, Gonoi W, Okuma H, Shirota G, Shintani Y, Abe H, Takazawa Y, Fukayama M, Ohtomo K. Common Postmortem Computed Tomography Findings Following Atraumatic Death: Differentiation between Normal Postmortem Changes and Pathologic Lesions. Korean J Radiol 2015; 16:798-809. [PMID: 26175579 PMCID: PMC4499544 DOI: 10.3348/kjr.2015.16.4.798] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 03/16/2015] [Indexed: 11/25/2022] Open
Abstract
Computed tomography (CT) is widely used in postmortem investigations as an adjunct to the traditional autopsy in forensic medicine. To date, several studies have described postmortem CT findings as being caused by normal postmortem changes. However, on interpretation, postmortem CT findings that are seemingly due to normal postmortem changes initially, may not have been mere postmortem artifacts. In this pictorial essay, we describe the common postmortem CT findings in cases of atraumatic in-hospital death and describe the diagnostic pitfalls of normal postmortem changes that can mimic real pathologic lesions.
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Affiliation(s)
- Masanori Ishida
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
- Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo 101-8326, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hidemi Okuma
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Go Shirota
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yukako Shintani
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yutaka Takazawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Kuni Ohtomo
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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Abe K, Kobayashi T, Shiotani S, Saito H, Kaga K, Tashiro K, Someya S, Hayakawa H, Homma K. Optimization of Inversion Time for Postmortem Fluid-attenuated Inversion Recovery (FLAIR) MR Imaging at 1.5T: Temperature-based Suppression of Cerebrospinal Fluid. Magn Reson Med Sci 2015; 14:251-5. [PMID: 25833274 DOI: 10.2463/mrms.2014-0086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Signal intensity (SI) and image contrast on postmortem magnetic resonance (MR) imaging are different from those of imaging of living bodies. We sought to suppress the SI of cerebrospinal fluid (CSF) sufficiently for fluid-attenuated inversion recovery (FLAIR) sequence in postmortem MR (PMMR) imaging by optimizing inversion time (TI). MATERIALS AND METHODS We subject 28 deceased patients to PMMR imaging 3 to 113 hours after confirmation of death (mean, 27.4 hrs.). PMMR imaging was performed at 1.5 tesla, and T1 values of CSF were measured with maps of relaxation time. Rectal temperatures (RT) measured immediately after PMMR imaging ranged from 6 to 32°C (mean, 15.4°C). We analyzed the relationship between T1 and RT statistically using Pearson's correlation coefficient. We obtained FLAIR images from one cadaver using both a TI routinely used for living bodies and an optimized TI calculated from the RT. RESULTS T1 values of CSF ranged from 2159 to 4063 ms (mean 2962.4), and there was a significantly positive correlation between T1 and RT (r = 0.96, P < 0.0001). The regression expression for the relationship was T1 = 74.4 * RT + 1813 for a magnetic field strength of 1.5T. The SI of CSF was effectively suppressed with the optimized TI (0.693 * T1), namely, TI = 0.693 * (77.4 * RT + 1813). CONCLUSION Use of the TI calculated from the linear regression of the T1 and RT optimizes the FLAIR sequence of PMMR imaging.
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Affiliation(s)
- Kazuyuki Abe
- Department of Radiological Science, Faculty of Health Sciences, Junshin Gakuen University
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35
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Fluid in the airway of nontraumatic death on postmortem computed tomography: relationship with pleural effusion and postmortem elapsed time. Am J Forensic Med Pathol 2015; 35:113-7. [PMID: 24781399 DOI: 10.1097/paf.0000000000000083] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To evaluate radiographic features of endotracheal/endobronchial fluid in the airway (FA) observed on postmortem computed tomography (PMCT). We studied 164 subjects who died at our hospital between April 2009 and September 2012. Fluid in the airway was considered positive when fluid was identified in the lumen of 1 of the 2 main bronchi in continuity with a segmental bronchus. Pleural effusion and atelectasis/consolidation of the lung lower lobes were also evaluated. Fluid in the airway was observed in 60 (71%) of 84 subjects with unilateral or bilateral pleural effusion, and in 44 (55%) of 80 subjects without pleural effusion (P = 0.029). Of the latter, 41 (93%) had atelectasis/consolidation of the lower lung lobes. Among subjects without pleural effusion, average times after death to PMCT of subjects with and without FA were 501 and 314 minutes, respectively (P = 0.01). Time-course analysis showed that cases with FA on PMCT largely correlated with time after death (R = 0.7966). Fluid in the airway is frequently observed on PMCT in subjects with pleural effusion or atelectasis/consolidation of the lung. No FA in subjects without pleural effusion correlated to shorter times after death. In addition, FA frequency on PMCT increased over time after death.
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TASHIRO K, SHIOTANI S, KOBAYASHI T, KAGA K, SAITO H, SOMEYA S, MIYAMOTO K, HAYAKAWA H. Cerebral Relaxation Times from Postmortem MR Imaging of Adults. Magn Reson Med Sci 2015; 14:51-6. [DOI: 10.2463/mrms.2013-0126] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kazuya TASHIRO
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Seiji SHIOTANI
- Department of Radiology, Tsukuba Medical Center Hospital
| | - Tomoya KOBAYASHI
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Kazunori KAGA
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Hajime SAITO
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Satoka SOMEYA
- Department of Radiological Technology, Tsukuba Medical Center Hospital
| | - Katsumi MIYAMOTO
- Department of Radiological Technology, Tsukuba Medical Center Hospital
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Morgan B, Adlam D, Robinson C, Pakkal M, Rutty GN. Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging. Br J Radiol 2014; 87:20130662. [PMID: 24338941 DOI: 10.1259/bjr.20130662] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The use of post-mortem imaging is expanding throughout the world with increasing use of advanced imaging techniques, such as contrast-enhanced CT and MRI. The questions asked of post-mortem imaging are complex and can be very different, for example for natural sudden death investigation will focus on the cause, whereas for trauma the cause of death is often clear, but injury patterns may be very revealing in investigating the background to the incident. Post-mortem imaging is different to clinical imaging regarding both the appearance of pathology and the information required, but there is much to learn from many years of clinical research in the use of these techniques. Furthermore, it is possible that post-mortem imaging research could be used not only for investigating the cause of death but also as a model to conduct clinically relevant research. This article reviews challenges to the development of post-mortem imaging for trauma, identification and cardiorespiratory death, and how they may be influenced by current clinical thinking and practice.
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Affiliation(s)
- B Morgan
- Imaging Department, University Hospitals of Leicester, Leicester Royal Infirmary, Leicester, UK
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Ruder TD, Thali MJ, Hatch GM. Essentials of forensic post-mortem MR imaging in adults. Br J Radiol 2014; 87:20130567. [PMID: 24191122 DOI: 10.1259/bjr.20130567] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Post-mortem MR (PMMR) imaging is a powerful diagnostic tool with a wide scope in forensic radiology. In the past 20 years, PMMR has been used as both an adjunct and an alternative to autopsy. The role of PMMR in forensic death investigations largely depends on the rules and habits of local jurisdictions, availability of experts, financial resources, and individual case circumstances. PMMR images are affected by post-mortem changes, including position-dependent sedimentation, variable body temperature and decomposition. Investigators must be familiar with the appearance of normal findings on PMMR to distinguish them from disease or injury. Coronal whole-body images provide a comprehensive overview. Notably, short tau inversion-recovery (STIR) images enable investigators to screen for pathological fluid accumulation, to which we refer as "forensic sentinel sign". If scan time is short, subsequent PMMR imaging may be focussed on regions with a positive forensic sentinel sign. PMMR offers excellent anatomical detail and is especially useful to visualize pathologies of the brain, heart, subcutaneous fat tissue and abdominal organs. PMMR may also be used to document skeletal injury. Cardiovascular imaging is a core area of PMMR imaging and growing evidence indicates that PMMR is able to detect ischaemic injury at an earlier stage than traditional autopsy and routine histology. The aim of this review is to present an overview of normal findings on forensic PMMR, provide general advice on the application of PMMR and summarise the current literature on PMMR imaging of the head and neck, cardiovascular system, abdomen and musculoskeletal system.
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Affiliation(s)
- T D Ruder
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
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Times have changed! Forensic radiology--a new challenge for radiology and forensic pathology. AJR Am J Roentgenol 2014; 202:W325-34. [PMID: 24660730 DOI: 10.2214/ajr.12.10283] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The ongoing development of imaging and the recent integration of cross-sectional imaging methods into the medicolegal workflow have resulted in an increasing number of forensic institutes acquiring dedicated CT and MRI scanners. The purpose of this article is to evaluate the different aspects of postmortem imaging and to detail the necessary cooperation between radiologists and forensic pathologists for mutual learning and accurate science to form a new subspecialty: forensic radiology. CONCLUSION; Forensic radiology must integrate the expertise of forensic pathologists and radiologists. The challenge is to unite these two disciplines first by direct and intense communications and second by a basic understanding of forensic pathology by radiologists as well as a foundational knowledge of postmortem imaging by forensic pathologists, in combination with the establishment of educational and reporting guidelines.
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Kobayashi T, Monma M, Baba T, Ishimori Y, Shiotani S, Saitou H, Kaga K, Miyamoto K, Hayakawa H, Homma K. Optimization of inversion time for postmortem short-tau inversion recovery (STIR) MR imaging. Magn Reson Med Sci 2014; 13:67-72. [PMID: 24769635 DOI: 10.2463/mrms.2013-0046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Signal intensity and image contrast differ between postmortem magnetic resonance (PMMR) images and images acquired from the living body. We sought to achieve sufficient fat suppression with short-tau inversion recovery (STIR) PMMR imaging by optimizing inversion time (TI). MATERIAL AND METHODS We subjected 37 deceased adult patients to PMMR imaging at 1.5 tesla 8 to 60 hours after confirmation of death and measured T1 values of areas of subcutaneous fat with relaxation time maps. Rectal temperature (RT) measured immediately after PMMR ranged from 6 to 31°C. We used Pearson's correlation coefficient to analyze the relationship between T1 and relaxation time (RT). We compared STIR images from 4 cadavers acquired with a TI commonly used in the living body and another TI calculated from the linear regression of T1 and RT. RESULTS T1 values of subcutaneous fat ranged from 89.4 to 182.2 ms. There was a strong, positive, and significant correlation between T1 and RT (r = 0.91, P < 0.0001). The regression expression for the relationship was T1 = 2.6*RT + 90 at a field strength of 1.5T. The subcutaneous fat signal was suppressed more effectively with the optimized TI. CONCLUSION The T1 value of subcutaneous fat in PMMR correlates linearly with body temperature. Using this correlation to determine TI, fat suppression with PMMR STIR imaging can be easily improved.
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Affiliation(s)
- Tomoya Kobayashi
- Department of Radiological Technology, Tsukuba Medical Center Hospital
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Okuma H, Gonoi W, Ishida M, Shintani Y, Takazawa Y, Fukayama M, Ohtomo K. Greater thickness of the aortic wall on postmortem computed tomography compared with antemortem computed tomography: the first longitudinal study. Int J Legal Med 2013; 128:987-93. [PMID: 24352561 DOI: 10.1007/s00414-013-0955-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To evaluate postmortem changes of the aorta on postmortem computed tomography (CT) in comparison with those on antemortem CT obtained in the same patients. MATERIALS AND METHODS We studied 57 consecutive patients who had undergone antemortem CT, postmortem CT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. Postmortem CT was performed within 20 h after death, followed by pathological autopsy. Pathological autopsy confirmed the absence of cardiovascular disease such as aortic aneurysm, aortic dissection, or Marfan syndrome in all patients. Aortic wall thickness and aortic cross-sectional areas were measured on both antemortem CT and postmortem CT. Difference in aortic wall thickness between antemortem CT with and without contrast medium, and between antemortem CT and postmortem CT, and in cross-sectional area of the aortic wall between antemortem CT and postmortem CT was evaluated statistically. RESULTS No significant difference in aortic wall thickness was observed on antemortem CT in comparison of contrasted and non-contrasted images. The aortic wall was significantly thicker on postmortem CT than on antemortem CT (p < 0.0001). No significant difference in cross-sectional area of the aortic wall was observed between antemortem CT and postmortem CT measurements. CONCLUSION This is the first longitudinal study to confirm greater thickness of the aortic wall on postmortem images compared with antemortem images in the same patients and to show no change in cross-sectional area of the aortic wall between before and after death.
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Affiliation(s)
- Hidemi Okuma
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
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Okuma H, Gonoi W, Ishida M, Shintani Y, Takazawa Y, Fukayama M, Ohtomo K. Heart wall is thicker on postmortem computed tomography than on antemortem [corrected] computed tomography: the first longitudinal study. PLoS One 2013; 8:e76026. [PMID: 24086680 PMCID: PMC3785517 DOI: 10.1371/journal.pone.0076026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 08/22/2013] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate the postmortem changes of the heart wall on postmortem (PM) computed tomography (CT) in comparison with those on ante mortem CT (AMCT), and in comparison with the pathological findings, obtained in the same patients. Materials and Methods We studied 57 consecutive patients who had undergone AMCT, PMCT, and pathological autopsy in our tertiary care hospital between April 2009 and December 2010. PMCT was performed within 20 hours after death, followed by pathological autopsy. The cardiac chambers were measured at five sites on both AMCT and PMCT by two board-certified radiologists who were not provided with clinical information. The differences in heart wall thickness between AMCT with and without contrast medium, between AMCT and PMCT, and between PMCT and pathological anatomy were evaluated statistically. Confounding factors of postmortem change such as gender, presence of arteriosclerosis, the organ related to cause of death, age, and elapsed time since death were examined statistically. Results No significant differences were observed on AMCT in comparison of contrasted and non-contrasted images. The heart wall was significantly thicker on PMCT than on AMCT (p < 0.0001) at all five measurement sites. The heart wall was significantly thicker on PMCT than on pathology specimens when measured in accordance with pathological standard mensuration. However, no significant difference was observed between PMCT measurements and those of pathology specimens at any site when the papillary muscles and epicardial fat were included. No significant association was found between postmortem change in heart wall thickness and gender, presence of arteriosclerosis, the organ related to cause of death, age, or elapsed time since death. Conclusion This is the first longitudinal study to confirm greater thickness of heart wall on postmortem images compared with ante mortem images, in the same patients. Furthermore, the postmortem changes on CT were supported by the pathological findings.
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Affiliation(s)
- Hidemi Okuma
- Department of Radiology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
- * E-mail:
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Masanori Ishida
- Department of Radiology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
- Department of Radiology, Mutual Aid Association for Tokyo Metropolitan Teachers and Officials, Sanraku Hospital, Tokyo, Japan
| | - Yukako Shintani
- Department of Pathology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yutaka Takazawa
- Department of Pathology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Kuni Ohtomo
- Department of Radiology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
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Nolan MW, Randall EK, LaRue SM, Lunn KF, Stewart J, Kraft SL. Accuracy of CT and MRI for contouring the feline optic apparatus for radiation therapy planning. Vet Radiol Ultrasound 2013; 54:560-6. [PMID: 23738866 DOI: 10.1111/vru.12070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 05/02/2013] [Indexed: 11/29/2022] Open
Abstract
Consistency and accuracy in normal tissue contouring in radiotherapy planning is important for comparison of dosimetry and toxicity data between studies. The purpose of this study was to determine whether magnetic resonance imaging (MRI) improves the accuracy of optic apparatus contouring as compared with computed tomography (CT) in both normal and acromegalic cats, and to construct a reference contour of the feline optic apparatus. Both CT and MRI were performed on cadavers of four healthy cats, as well as on five radiotherapy patients with feline acromegaly. Contours of the optic apparatus were drawn for each imaging study. The volume, center of mass, and the degree of concordance and mismatch were determined for each, and compared with a reference standard. Precontrast CT was found to overestimate volume as compared with MRI in acromegalic cats; no other statistically significant differences were identified in the volume, concordance index or mismatch index values of normal or acromegalic cats. Contours derived from T2-wieghted MRI were subjectively considered to best match the reference standard. The caudal margin of the optic chiasm and the optic tracts were difficult to confidently contour regardless of which imaging modality and/or sequence was used. In conclusion, findings from the current study supported the use of a combination of CT and MR images and a priori knowledge of the shape of the optic apparatus to guide accurate contouring, especially where image contrast is not sufficient to clearly delineate the margins. Guidelines for feline optic apparatus contouring developed in this study can be used for future studies.
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Affiliation(s)
- Michael W Nolan
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, 80523
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A rare case of suicide by gunshot with nasal entry assessed by classical autopsy, post-mortem computed tomography (PMCT) and post-mortem magnetic resonance imaging (PMMR). ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jofri.2013.03.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
OBJECTIVE The aim of this study was to determine the sensitivity and specificity of postmortem whole-body MRI for typical injuries resulting from traumatic causes of death. MATERIALS AND METHODS Forty cases of accidental death were evaluated with postmortem whole-body MRI. Imaging was conducted according to a standard protocol, and each examination had an average duration of 90 minutes. The imaging findings were correlated with the autopsy findings, which served as the reference standard. RESULTS MRI showed the main pathologic process leading to death in 39 of the 40 cases. The sensitivity of postmortem MRI ranged from 100% (pneumothorax) to 40% (fractures of the upper extremities). In general, MRI had a high level of performance for depicting soft-tissue lesions, such as subcutaneous hematoma (e.g., galeal hematoma with a sensitivity 95%). The sensitivity of MRI was remarkably lower for lesions of the upper abdominal organs (liver, 80%; spleen, 50%; pancreas, 60%; kidneys, 66%). CONCLUSION Postmortem whole-body MRI had overall good performance for depicting traumatic findings in corpses and therefore may serve an important role as an adjunct to classic autopsy for the forensic examination of cases of traumatic cause of death. However, the reduced sensitivity of postmortem MRI for lacerations of the upper abdominal organs and the observed superimposition of antemortem findings and postmortem findings (e.g., in the pulmonary tissue) in this retrospective study suggest that whole-body postmortem MRI not be recommended as a replacement for classic autopsy.
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Background and current status of postmortem imaging in Japan: short history of "Autopsy imaging (Ai)". Forensic Sci Int 2012; 225:3-8. [PMID: 22480884 DOI: 10.1016/j.forsciint.2012.03.010] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 03/02/2012] [Accepted: 03/06/2012] [Indexed: 11/24/2022]
Abstract
There is a low autopsy rate and wide distribution of computed tomography (CT) and magnetic resonance imaging (MRI) scanners in Japan. Therefore, many Japanese hospitals, including 36% of the hospitals with in-patient facilities and 89% of large hospitals with ER facilities conduct postmortem imaging (PMI), use clinical scanners to screen for causes in unusual deaths as an alternative to an autopsy or to determine whether an autopsy is needed. The Japanese PMI examination procedure is generally referred to as "autopsy imaging" (Ai) and the term "Ai" is now commonly used by the Japanese government. Currently, 26 of 47 Japanese prefectures have at least one Ai Center with scanners that are dedicated for PMI. Here, we briefly review the history of Japanese PMI (Ai) from 1985 to the present.
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Ruder TD, Hatch GM, Ebert LC, Flach PM, Ross S, Ampanozi G, Thali MJ. Whole Body Postmortem Magnetic Resonance Angiography. J Forensic Sci 2011; 57:778-82. [DOI: 10.1111/j.1556-4029.2011.02037.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ishida M, Gonoi W, Hagiwara K, Takazawa Y, Akahane M, Fukayama M, Ohtomo K. Hypostasis in the heart and great vessels of non-traumatic in-hospital death cases on postmortem computed tomography: relationship to antemortem blood tests. Leg Med (Tokyo) 2011; 13:280-5. [PMID: 22000062 DOI: 10.1016/j.legalmed.2011.09.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 09/14/2011] [Accepted: 09/15/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate hypostasis in the heart and great vessels (HHGV) by postmortem computed tomography (PMCT) in cases of non-traumatic in-hospital deaths and to analyze relationships between clarity of HHGV and antemortem blood markers. MATERIAL AND METHODS The study included 31 cadavers of patients who died while receiving treatment in our academic tertiary-care hospital between April and December 2009. Antemortem blood tests including both hematological and blood coagulation markers were performed within 48h before death, and PMCT and conventional autopsies were performed. The findings of HHGV were assessed in the following six locations: the superior vena cava, right atrium, right ventricle, thoracic aorta, left atrium, and left ventricle. The clarity of HHGV on PMCT was divided into two groups using attenuation of the left ventricular wall as a reference: no/obscure HHGV group and clear HHGV group. The relationships between clarity of HHGV and six blood markers [red blood cell (RBC) count, hemoglobin (Hb), hematocrit (Ht), prothrombin percentage activity (PT%), activated partial thromboplastin time (aPTT), and fibrinogen] were evaluated statistically. RESULTS We observed no/obscure HHGV in 14 patients (45%) and clear HHGV in 17 patients (55%). The level of fibrinogen in clear HHGV group was significantly higher than in no/obscure HHGV group (P=0.029). No relationships were found between clarity of HHGV and other five blood markers. CONCLUSION HHGV is a common PMCT finding. Clear HHGV on PMCT was related to higher level of fibrinogen in non-traumatic in-hospital death cases.
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Affiliation(s)
- Masanori Ishida
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
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Ishida M, Gonoi W, Hagiwara K, Takazawa Y, Akahane M, Fukayama M, Ohtomo K. Postmortem changes of the thyroid on computed tomography. Leg Med (Tokyo) 2011; 13:318-22. [PMID: 21940188 DOI: 10.1016/j.legalmed.2011.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 08/24/2011] [Accepted: 08/25/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the radiographic features of the thyroid on postmortem computed tomography (PMCT). METHODS We studied the bodies of 32 subjects who had been treated and subsequently died in our tertiary care hospital between April and December 2009. The thyroids were imaged by antemortem computed tomography (AMCT), PMCT, and examined by conventional autopsy. Differences between the radiographic features of the thyroid on AMCT and PMCT, and time since AMCT were evaluated statistically. RESULTS CT values of the thyroid decreased after death with an average of 114.2 Hounsfield Units (HUs) on AMCT vs. 107.7HU on PMCT (paired t-test, P=0.023). There was no correlation between the elapsed time from AMCT and differences of CT values of the thyroid on AMCT and PMCT (Spearman's rank correlation test, P>0.05). CONCLUSION We showed that CT values of the thyroid decreased after death.
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Affiliation(s)
- Masanori Ishida
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
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Scheurer E, Lovblad KO, Kreis R, Maier SE, Boesch C, Dirnhofer R, Yen K. Forensic application of postmortem diffusion-weighted and diffusion tensor MR imaging of the human brain in situ. AJNR Am J Neuroradiol 2011; 32:1518-24. [PMID: 21659482 DOI: 10.3174/ajnr.a2508] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DWI and DTI of the brain have proved to be useful in many neurologic disorders and in traumatic brain injury. This prospective study aimed at the evaluation of the influence of the PMI and the cause of death on the ADC and FA for the application of DWI and DTI in forensic radiology. MATERIALS AND METHODS DWI and DTI of the brain were performed in situ in 20 deceased subjects with mapping of the ADC and FA. Evaluation was performed in different ROIs, and the influence of PMI and cause of death was assessed. RESULTS Postmortem ADC values of the brain were decreased by 49%-72% compared with healthy living controls. With increasing PMI, ADCs were significantly reduced when considering all ROIs together and, particularly, GM regions (all regions, P < .05; GM, P < .01), whereas there was no significant effect in WM. Concerning the cause of death, ADCs were significantly lower in mechanical and hypoxic brain injury than in brains from subjects having died from heart failure (traumatic brain injury, P < .005; hypoxia, P < .001). Postmortem FA was not significantly different from FA in living persons and showed no significant influence of PMI or cause of death. CONCLUSIONS Performing postmortem DWI and DTI of the brain in situ can provide valuable information for application in forensic medicine. ADC could be used as an indicator of PMI and could help in the assessment of the cause of death.
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Affiliation(s)
- E Scheurer
- Ludwig Boltzmann Institute for Clinical-Forensic Imaging, Graz, Austria.
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