Differentiation of hemopericardium due to ruptured myocardial infarction or aortic dissection on unenhanced postmortem computed tomography.

Ampanozi, Garyfalia; Flach, Patricia M; Ruder, Thomas; Filograna, Laura; Schweitzer, Wolf; Thali, Michael J; Ebert, Lars C (2017). Differentiation of hemopericardium due to ruptured myocardial infarction or aortic dissection on unenhanced postmortem computed tomography. Forensic science, medicine, and pathology, 13(2), pp. 170-176. Springer 10.1007/s12024-017-9854-9

[img] Text
Differentiation of hemopericardium due to ruptured myocardial infarction.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (476kB) | Request a copy

The aim of the study was to evaluate unenhanced postmortem computed tomography (PMCT) in cases of non-traumatic hemopericardium by establishing the sensitivity, specificity and accuracy of diagnostic criteria for the differentiation between aortic dissection and myocardial wall rupture due to infarction. Twenty six cases were identified as suitable for evaluation, of which ruptured aortic dissection could be identified as the underlying cause of hemopericardium in 50% of the cases, and myocardial wall rupture also in 50% of the cases. All cases underwent a PMCT and 24 of the cases also underwent one or more additional examinations: a subsequent autopsy, or a postmortem magnetic resonance (PMMR), or a PMCT angiography (PMCTA), or combinations of the above. Two radiologists evaluated the PMCT images and classified each case as "aortic dissection", "myocardial wall rupture" or "undetermined". Quantification of the pericardial blood was carried out using segmentation techniques. 17 of 26 cases were correctly identified, either as aortic dissections or myocardial ruptures, by both readers. 7 of 13 myocardial wall ruptures were identified by both readers, whereas both readers identified correctly 10 of 13 aortic dissection cases. Taking into account the responses of both readers, specificity was 100% for both causes of hemopericardium and sensitivity as well as accuracy was higher for aortic dissections than myocardial wall ruptures (72.7% and 87.5% vs 53.8% and 75% respectively). Pericardial blood volumes were constantly higher in the aortic dissection group, but a statistical significance of these differences could not be proven, since the small count of cases did not allow for statistical tests. This study showed that diagnostic criteria for the differentiation between ruptured aortic dissection and myocardial wall rupture due to infarction are highly specific and accurate.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Ruder, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1556-2891

Publisher:

Springer

Language:

English

Submitter:

Nicole Rösch

Date Deposited:

22 Feb 2018 11:47

Last Modified:

22 Feb 2018 11:47

Publisher DOI:

10.1007/s12024-017-9854-9

PubMed ID:

28352988

Uncontrolled Keywords:

Aortic dissection Forensic radiology Hemopericardium Myocardial infarction Postmortem computed tomography (PMCT) Virtopsy

BORIS DOI:

10.7892/boris.107835

URI:

https://boris.unibe.ch/id/eprint/107835

Actions (login required)

Edit item Edit item
Provide Feedback