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利用定量尸检心脏1.5T磁共振成像检测和区分心肌梗死的早期急性期及后续各阶段。

Detection and differentiation of early acute and following age stages of myocardial infarction with quantitative post-mortem cardiac 1.5T MR.

作者信息

Schwendener Nicole, Jackowski Christian, Persson Anders, Warntjes Marcel J, Schuster Frederick, Riva Fabiano, Zech Wolf-Dieter

机构信息

Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland.

Center for Medical Image Science and Visualization, CMIV, Linköping University, SE-58183 Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.

出版信息

Forensic Sci Int. 2017 Jan;270:248-254. doi: 10.1016/j.forsciint.2016.10.014. Epub 2016 Oct 24.

Abstract

Recently, quantitative MR sequences have started being used in post-mortem imaging. The goal of the present study was to evaluate if early acute and following age stages of myocardial infarction can be detected and discerned by quantitative 1.5T post-mortem cardiac magnetic resonance (PMCMR) based on quantitative T1, T2 and PD values. In 80 deceased individuals (25 female, 55 male), a cardiac MR quantification sequence was performed prior to cardiac dissection at autopsy in a prospective study. Focal myocardial signal alterations detected in synthetically generated MR images were MR quantified for their T1, T2 and PD values. The locations of signal alteration measurements in PMCMR were targeted at autopsy heart dissection and cardiac tissue specimens were taken for histologic examinations. Quantified signal alterations in PMCMR were correlated to their according histologic age stage of myocardial infarction. In PMCMR seventy-three focal myocardial signal alterations were detected in 49 of 80 investigated hearts. These signal alterations were diagnosed histologically as early acute (n=39), acute (n=14), subacute (n=10) and chronic (n=10) age stages of myocardial infarction. Statistical analysis revealed that based on their quantitative T1, T2 and PD values, a significant difference between all defined age groups of myocardial infarction can be determined. It can be concluded that quantitative 1.5T PMCMR quantification based on quantitative T1, T2 and PD values is feasible for characterization and differentiation of early acute and following age stages of myocardial infarction.

摘要

最近,定量磁共振序列已开始用于尸检成像。本研究的目的是评估基于定量T1、T2和PD值的1.5T尸检心脏磁共振成像(PMCMR)能否检测和区分心肌梗死的早期急性期及后续各阶段。在一项前瞻性研究中,对80名死者(25名女性,55名男性)在尸检时进行心脏解剖前进行了心脏磁共振定量序列检查。对合成磁共振图像中检测到的局灶性心肌信号改变进行T1、T2和PD值的磁共振定量分析。在尸检心脏解剖时确定PMCMR中信号改变测量的位置,并采集心脏组织标本进行组织学检查。PMCMR中定量的信号改变与其相应的心肌梗死组织学阶段相关。在PMCMR中,80例受检心脏中的49例检测到73处局灶性心肌信号改变。这些信号改变经组织学诊断为心肌梗死的早期急性期(n = 39)、急性期(n = 14)、亚急性期(n = 10)和慢性期(n = 10)。统计分析表明,根据其定量T1、T2和PD值,可以确定所有定义的心肌梗死年龄组之间存在显著差异。可以得出结论,基于定量T1、T2和PD值的1.5T PMCMR定量分析对于心肌梗死早期急性期及后续阶段的特征描述和区分是可行的。

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