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Temperature-corrected postmortem 3-T MR quantification of histopathological early acute and chronic myocardial infarction: a feasibility study

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Abstract

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.

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Abbreviations

ms:

Milliseconds

MRI:

Magnetic resonance imaging

PMI:

Postmortem interval

QPMCMR:

Quantitative postmortem cardiac magnetic resonance

ROC:

Receiver operator characteristic

ROI:

Region of interest

T:

Tesla

T2w:

T2-weighted

TE:

Echo time

TR:

Repetition time

TSE:

Turbo spin echo

PD:

Proton density

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Acknowledgements

We would like to thank our teams of forensic pathologists, forensic technicians, histology technicians, and radiologic nurses for their support with case handling. We also thank Mats Fredrikson for his support with statistical analysis.

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Authors and Affiliations

  1. Center for Medical Image Science and Visualization (CMIV), University of Linköping, Linköping, Sweden

    Anders Persson, Marcel Warntjes & Wolf-Dieter Zech

  2. Department of Forensic Medicine, National Board of Forensic Medicine Linköping, Linköping, Sweden

    John Baeckmann, Johan Berge & Wolf-Dieter Zech

  3. Institute of Forensic Medicine Bern, University of Bern, Bühlstrasse 20, 3012, Bern, CH, Switzerland

    Christian Jackowski & Wolf-Dieter Zech

Authors
  1. Anders Persson
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  2. John Baeckmann
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  3. Johan Berge
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  4. Christian Jackowski
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  5. Marcel Warntjes
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  6. Wolf-Dieter Zech
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Correspondence to Wolf-Dieter Zech.

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Persson, A., Baeckmann, J., Berge, J. et al. Temperature-corrected postmortem 3-T MR quantification of histopathological early acute and chronic myocardial infarction: a feasibility study. Int J Legal Med 132, 541–549 (2018). https://doi.org/10.1007/s00414-017-1614-6

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  • DOI: https://doi.org/10.1007/s00414-017-1614-6

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