Forensic Imaging Center Bern, Institute of Forensic Medicine, University of Bern, Buehlstr. 20, 3012 Bern, Switzerland.
Eur Radiol. 2013 May;23(5):1266-70. doi: 10.1007/s00330-012-2728-3. Epub 2012 Dec 16.
To investigate unenhanced postmortem 3-T MR imaging (pmMRI) for the detection of pulmonary thrombembolism (PTE) as cause of death.
In eight forensic cases dying from a possible cardiac cause but with homogeneous myocardium at cardiac pmMRI, additional T2w imaging of the pulmonary artery was performed before forensic autopsy. Imaging was carried out on a 3-T MR system in the axial and main pulmonary artery adapted oblique orientation in situ. In three cases axial T2w pmMRI of the lower legs was added. Validation of imaging findings was performed during forensic autopsy.
All eight cases showed homogeneous material of intermediate signal intensity within the main pulmonary artery and/or pulmonary artery branches. Autopsy confirmed the MR findings as pulmonary artery thrombembolism. At lower leg imaging unilateral dilated veins and subcutaneous oedema with or without homogeneous material of intermediate signal intensity within the popliteal vein were found.
Unenhanced pmMRI demonstrates pulmonary thrombembolism in situ. PmMR may serve as an alternative to clinical autopsy, especially when consent cannot be obtained.
• Postmortem MRI (pmMRI) provides an alternative to clinical autopsy • Fatal pulmonary thrombembolism (PTE) can now be diagnosed using postmortem MRI (pmMRI). • Special attention has to be drawn to the differentiation of postmortem clots.
探讨非增强式死后 3T MRI（pmMRI）在检测肺血栓栓塞症（PTE）作为死亡原因中的作用。
在 8 例因可能的心脏原因死亡但心脏 pmMRI 显示心肌均匀的法医学案例中，在法医尸检前对肺动脉进行了额外的 T2w 成像。成像在轴向和主肺动脉适应的原位斜位在 3T MR 系统上进行。在 3 例情况下，还进行了下肢轴向 T2w pmMRI。在法医尸检期间对成像结果进行了验证。
所有 8 例均显示主肺动脉和/或肺动脉分支内具有中等信号强度的均匀物质。尸检证实了 MRI 发现为肺动脉血栓栓塞症。下肢成像显示单侧扩张的静脉和皮下水肿，伴或不伴腘静脉内具有中等信号强度的均匀物质。
非增强式 pmMRI 可在原位显示肺血栓栓塞症。pmMRI 可作为临床尸检的替代方法，尤其是在无法获得同意的情况下。
• 死后 MRI（pmMRI）为临床尸检提供了替代方法。
• 现在可以使用死后 MRI（pmMRI）诊断致命性肺血栓栓塞症（PTE）。
• 特别需要注意死后血栓的鉴别。
