Hindsø Louise, Jakobsen Lykke S, Jacobsen Christina, Lynnerup Niels, Banner Jytte
Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Frederik V's vej 11, 2100, Copenhagen East, Denmark.
Forensic Sci Med Pathol. 2017 Dec;13(4):468-472. doi: 10.1007/s12024-017-9930-1. Epub 2017 Nov 2.
Epicardial adipose tissue (EAT) may play a role in the development of coronary artery disease. The purpose of this study was to evaluate a method based on postmortem computed tomography (PMCT) for the estimation of EAT volume. We PMCT-scanned the eviscerated hearts of 144 deceased individuals, who underwent a medicolegal autopsy. Using Mimics® we performed segmentation of the images and obtained the volumes of EAT and myocardium. Total heart volume was calculated by adding the volumes of EAT and myocardium. Total heart weight, including EAT, myocardium and attached vessels, was measured during autopsy. Inter-observer analysis was performed on 30 randomly chosen subjects. We included 132 individuals in the results (age range: 22-94 years; 56% men). Twelve individuals were excluded due to inadequate PMCT scanning. Median EAT volume was 73.0 mL (Interquartile range; IQR: 45.6-113.7 mL) in men and 64.8 mL (IQR: 44.0-98.0 mL) in women, which accounted for 20.4 ± 10.2% and 21.9 ± 9.5% of total heart volume, respectively. This corresponded with former autopsy studies. Total heart volume measured by PMCT was highly correlated with heart weight (R = 90%). Mean inter-observer difference of EAT volume was -1.7 mL (95% limits of agreement: -37.0-33.6 mL), with an Intra Class Correlation of 0.91. It was possible to estimate EAT volume using PMCT on eviscerated human hearts. Our method was fast and accurate with good inter-observer agreement. This is a useful method to determine EAT at autopsy, and we will apply this method in future research.
心外膜脂肪组织（EAT）可能在冠状动脉疾病的发展中起作用。本研究的目的是评估一种基于死后计算机断层扫描（PMCT）的EAT体积估计方法。我们对144名接受法医尸检的死者的去内脏心脏进行了PMCT扫描。使用Mimics®软件对图像进行分割，获得EAT和心肌的体积。通过将EAT和心肌的体积相加计算全心体积。在尸检过程中测量包括EAT、心肌和附着血管在内的全心重量。对30名随机选择的受试者进行了观察者间分析。我们将132名个体纳入结果分析（年龄范围：22 - 94岁；56%为男性）。12名个体因PMCT扫描不充分而被排除。男性的EAT体积中位数为73.0 mL（四分位间距；IQR：45.6 - 113.7 mL），女性为64.8 mL（IQR：44.0 - 98.0 mL），分别占全心体积的20.4±10.2%和21.9±9.5%。这与以前的尸检研究结果相符。通过PMCT测量的全心体积与心脏重量高度相关（R = 90%）。EAT体积的观察者间平均差异为 - 1.7 mL（95%一致性界限： - 37.0 - 33.6 mL），组内相关系数为0.91。使用PMCT对去内脏的人体心脏进行EAT体积估计是可行的。我们的方法快速、准确，观察者间一致性良好。这是一种在尸检时确定EAT的有用方法，我们将在未来的研究中应用此方法。
