Persson Anders, Baeckmann John, Berge Johan, Jackowski Christian, Warntjes Marcel, Zech Wolf-Dieter
Center for Medical Image Science and Visualization (CMIV), University of Linköping, Linköping, Sweden.
Department of Forensic Medicine, National Board of Forensic Medicine Linköping, Linköping, Sweden.
Int J Legal Med. 2018 Mar;132(2):541-549. doi: 10.1007/s00414-017-1614-6. Epub 2017 Jun 13.
The goal of the present study was to evaluate if quantitative postmortem cardiac 3-T magnetic resonance (QPMCMR) T1 and T2 relaxation times and proton density values of histopathological early acute and chronic myocardial infarction differ to the quantitative values of non-pathologic myocardium and other histopathological age stages of myocardial infarction with regard to varying corpse temperatures. In 60 forensic corpses (25 female, 35 male), a cardiac 3-T MR quantification sequence was performed prior to autopsy and cardiac dissection. Core body temperature was assessed during MR examinations. Focal myocardial signal alterations in synthetically generated MR images were measured for their T1, T2, and proton density (PD) values. Locations of signal alteration measurements in PMCMR were targeted at heart dissection, and myocardial tissue specimens were taken for histologic examinations. Quantified signal alterations in QPMCMR were correlated to their according histologic age stage of myocardial infarction, and quantitative values were corrected for a temperature of 37 °C. In QPMCMR, 49 myocardial signal alterations were detected in 43 of 60 investigated hearts. Signal alterations were diagnosed histologically as early acute (n = 16), acute (n = 10), acute with hemorrhagic component (n = 9), subacute (n = 3), and chronic (n = 11) myocardial infarction. Statistical analysis revealed that based on their temperature-corrected quantitative T1, T2, and PD values, a significant difference between early acute, acute, and chronic myocardial infarction can be determined. It can be concluded that quantitative 3-T postmortem cardiac MR based on temperature-corrected T1, T2, and PD values may be feasible for pre-autopsy diagnosis of histopathological early acute, acute, and chronic myocardial infarction, which needs to be confirmed histologically.
本研究的目的是评估在不同尸体温度下,组织病理学早期急性和慢性心肌梗死的定量尸检心脏3-T磁共振成像(QPMCMR)的T1和T2弛豫时间以及质子密度值,与非病理性心肌以及心肌梗死其他组织病理学年龄阶段的定量值相比是否存在差异。在60具法医尸体(25名女性,35名男性)中,在尸检和心脏解剖之前进行了心脏3-T MR定量序列检查。在MR检查期间评估核心体温。测量合成生成的MR图像中局灶性心肌信号改变的T1、T2和质子密度(PD)值。QPMCMR中信号改变测量的位置以心脏解剖为目标,并采集心肌组织标本进行组织学检查。QPMCMR中量化的信号改变与其相应的心肌梗死组织学年龄阶段相关,并将定量值校正至37°C的温度。在QPMCMR中,在60个被研究心脏中的43个中检测到49处心肌信号改变。信号改变经组织学诊断为早期急性(n = 16)、急性(n = 10)、伴有出血成分的急性(n = 9)、亚急性(n = 3)和慢性(n = 11)心肌梗死。统计分析表明,根据其温度校正后的定量T1、T2和PD值,可以确定早期急性、急性和慢性心肌梗死之间存在显著差异。可以得出结论,基于温度校正后的T1、T2和PD值的定量3-T尸检心脏MR可能对组织病理学早期急性、急性和慢性心肌梗死的尸检前诊断可行,这需要组织学确认。