Arthurs Owen J, Price Gemma C, Carmichael David W, Jones Rod, Norman Wendy, Taylor Andrew M, Sebire Neil J
Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK,
Eur Radiol. 2015 May;25(5):1399-406. doi: 10.1007/s00330-014-3525-y. Epub 2014 Dec 18.
To evaluate perinatal body organ apparent diffusion coefficient (ADC) values at postmortem magnetic resonance imaging (PMMR) in order to evaluate postmortem changes.
Postmortem diffusion-weighted imaging (DWI) of the thorax and abdomen were performed with diffusion gradient values b = 0, 500, and 1000 s/mm(2) on 15 foetal and childhood cases (mean 33.3 ± 7.8 weeks gestation) compared to 44 live infants (mean age 75.5 ± 53.4 days). Mean ADC values were calculated from regions of interest (ROIs) for the lungs, liver, spleen and renal cortex, compared to normative live infantile body ADC values of similar gestational age.
Mean ADC values were significantly lower in postmortem cases than in normal controls for liver (0.88 10(-3) mm(2)/s ± SD 0.39 vs. 1.13 ± 0.13; p < 0.05) and renal cortex (0.85 ± 0.26 vs. 1.19 ± 0.13; p < 0.05) but not spleen or muscle. Mean lung ADC values were significantly higher than normal controls (1.06 ± 0.18 vs. 0 ± 0; p < 0.001), and there was a significant correlation between postmortem interval and lung ADC (R(2) = 0.55).
Lung PMMR ADC values are related to postmortem interval, making them a potential marker of time since death. Further research is needed to understand the organ-specific changes which occur in the postmortem period.
• Liver and spleen PM ADC values were lower than controls. • Lung ADC changes correlate with PM interval. • These findings may be useful in medicolegal cases.
评估围产期尸体磁共振成像（PMMR）中身体器官的表观扩散系数（ADC）值，以评估死后变化。
对15例胎儿和儿童病例（平均孕周33.3±7.8周）进行胸部和腹部的死后扩散加权成像（DWI），扩散梯度值b = 0、500和1000 s/mm²，与44例活产婴儿（平均年龄75.5±53.4天）进行比较。从感兴趣区域（ROI）计算肺、肝、脾和肾皮质的平均ADC值，并与相似孕周的正常活产婴儿身体ADC值进行比较。
死后病例中，肝脏（0.88×10⁻³mm²/s±标准差0.39 vs. 1.13±0.13；p < 0.05）和肾皮质（0.85±0.26 vs. 1.19±0.13；p < 0.05）的平均ADC值显著低于正常对照组，但脾脏或肌肉无此情况。肺的平均ADC值显著高于正常对照组（1.06±0.18 vs. 0±0；p < 0.001），且死后间隔与肺ADC之间存在显著相关性（R² = 0.55）。
肺PMMR ADC值与死后间隔相关，使其成为死亡时间的潜在标志物。需要进一步研究以了解死后期间发生的器官特异性变化。
•肝脏和脾脏的PM ADC值低于对照组。•肺ADC变化与PM间隔相关。•这些发现可能在法医学案件中有用。
