Laboratorio de Investigacao Medica (LIM-05), Departamento de Patologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2021 Nov 26;76:e3543. doi: 10.6061/clinics/2021/e3543. eCollection 2021.
Ultrasound-guided minimally invasive autopsies (MIA-US) are an alternative to conventional autopsies and have been used in our institution to investigate the pathophysiology of COVID-19 since the beginning of the pandemic. Owing to the limitations of post-mortem biopsies for evaluating cardiopulmonary events involving large vessels, we continuously improved the technique during this period. Objectives: To demonstrate the usefulness of an extended MIA-US technique (EMIA-US) for the study of thoracic involvement in COVID-19.
US-guided percutaneous tissue sampling was combined with a small thoracic incision (≤5 cm), allowing for the sampling of larger tissue samples or even the entire organ (lungs and heart).
EMIA-US was performed for eight patients who died of COVID-19 in 2021. We demonstrate cardiopulmonary events, mainly thromboembolism and myocardial infarction, that could be evaluated using EMIA-US.
Minimally invasive image-guided post-mortem tissue sampling is a flexible and practical method to conduct post-mortem studies of human diseases, mainly in areas that do not have autopsy facilities or, alternatively, when autopsy is not possible owing to financial constraints, cultural and religious values, or for safety reasons, such as in the case of highly contagious infectious diseases. We present evidence that EMIA-US is feasible and can be used as an alternative to increase the accuracy of MIA-US in detecting cardiopulmonary events involving large vessels, which may not be assessed through post-mortem biopsies.
超声引导下微创解剖（MIA-US）是常规解剖的一种替代方法，自疫情开始以来，我院一直将其用于研究 COVID-19 的病理生理学。由于死后活检在评估涉及大血管的心肺事件方面存在局限性，在此期间，我们不断改进该技术。目的：展示扩展 MIA-US 技术（EMIA-US）在研究 COVID-19 胸部受累中的作用。
将超声引导下经皮组织取样与小的胸部切口（≤5cm）相结合，允许取样更大的组织样本，甚至整个器官（肺和心脏）。
2021 年，对 8 例死于 COVID-19 的患者进行了 EMIA-US。我们展示了心肺事件，主要是血栓栓塞和心肌梗死，这些可以通过 EMIA-US 进行评估。
微创影像引导下的死后组织取样是一种灵活实用的方法，可用于对人类疾病进行死后研究，主要适用于没有尸检设施的地区，或者由于经济限制、文化和宗教价值观，或者出于安全原因（如高度传染性传染病）无法进行尸检的情况下。我们提供的证据表明，EMIA-US 是可行的，可以作为增加 MIA-US 检测涉及大血管的心肺事件准确性的替代方法，这些事件可能无法通过死后活检评估。
