Feasibility of post mortem cardiac proton density weighted fast field echo imaging in two cases of sudden death

Crooijmans, Hendrikus J. A.; Ruder, Thomas D.; Eggert, Sebastian; Paula, Pia; Thali, Michael J.; Bieri, Oliver; Schweitzer, Wolf (2013). Feasibility of post mortem cardiac proton density weighted fast field echo imaging in two cases of sudden death. Legal medicine, 15(6), pp. 310-314. Elsevier 10.1016/j.legalmed.2013.09.003

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OBJECTIVE The aim of this work is to investigate and compare cardiac proton density (PD) weighted fast field echo (FFE) post-mortem magnetic resonance (PMMR) imaging with standard cardiac PMMR imaging (T1-weighted and T2-weighted turbo spin-echo (TSE)), postmortem CT (PMCT) as well as autopsy. MATERIALS AND METHODS Two human cadavers sequentially underwent cardiac PMCT and PMMR imaging (PD-weighted FFE, T1-weighted and T2-weighted TSE) and autopsy. The cardiac PMMR images were compared to each other as well as to PMCT and autopsy findings. RESULTS For the first case, cardiac PMMR exhibited a focal region of low signal in PD-weighted FFE and T2-weighted TSE images, surrounded by a signal intense rim in the T2-weighted images. T1-weighted TSE and PMCT did not appear to identify any focal abnormality. Macroscopic inspection identified a blood clot; histology confirmed this to be a thrombus with an adhering myocardial infarction. In the second case, a myocardial rupture with heart tamponade was identified in all PMMR images, located at the anterior wall of the left ventricle; PMCT excluded additional ruptures. In PD-weighted FFE and T2-weighted TSE images, it occurred hypo-intense, while resulting in small clustered hyper-intense spots in T1-weighted TSE. Autopsy confirmed the PMMR and PMCT findings. CONCLUSIONS Presented initial results have shown PD-weighted FFE to be a valuable imaging sequence in addition to traditional T2-weighted TSE imaging for blood clots and myocardial haemorrhage with clearer contrast between affected and healthy myocardium.

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:

1344-6223

Publisher:

Elsevier

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

13 May 2014 09:53

Last Modified:

13 May 2014 09:53

Publisher DOI:

10.1016/j.legalmed.2013.09.003

PubMed ID:

24139838

Uncontrolled Keywords:

Cardiac imaging, Fast field echo, Forensic radiology, Magnetic resonance imaging, Post-mortem magnetic resonance imaging, Virtopsy

URI:

https://boris.unibe.ch/id/eprint/52399

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