Post-mortem cardiac 3-T magnetic resonance imaging: visualization of sudden cardiac death?

Détails

ID Serval
serval:BIB_E163444D11EB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Post-mortem cardiac 3-T magnetic resonance imaging: visualization of sudden cardiac death?
Périodique
Journal of the American College of Cardiology
Auteur(s)
Jackowski C., Schwendener N., Grabherr S., Persson A.
ISSN
1558-3597 (Electronic)
ISSN-L
0735-1097
Statut éditorial
Publié
Date de publication
2013
Peer-reviewed
Oui
Volume
62
Numéro
7
Pages
617-629
Langue
anglais
Notes
Publication types: Journal Article
Résumé
OBJECTIVES: This study aimed to investigate post-mortem magnetic resonance imaging (pmMRI) for the assessment of myocardial infarction and hypointensities on post-mortem T2-weighted images as a possible method for visualizing the myocardial origin of arrhythmic sudden cardiac death.
BACKGROUND: Sudden cardiac death has challenged clinical and forensic pathologists for decades because verification on post-mortem autopsy is not possible. pmMRI as an autopsy-supporting examination technique has been shown to visualize different stages of myocardial infarction.
METHODS: In 136 human forensic corpses, a post-mortem cardiac MR examination was carried out prior to forensic autopsy. Short-axis and horizontal long-axis images were acquired in situ on a 3-T system.
RESULTS: In 76 cases, myocardial findings could be documented and correlated to the autopsy findings. Within these 76 study cases, a total of 124 myocardial lesions were detected on pmMRI (chronic: 25; subacute: 16; acute: 30; and peracute: 53). Chronic, subacute, and acute infarction cases correlated excellently to the myocardial findings on autopsy. Peracute infarctions (age range: minutes to approximately 1 h) were not visible on macroscopic autopsy or histological examination. Peracute infarction areas detected on pmMRI could be verified in targeted histological investigations in 62.3% of cases and could be related to a matching coronary finding in 84.9%. A total of 15.1% of peracute lesions on pmMRI lacked a matching coronary finding but presented with severe myocardial hypertrophy or cocaine intoxication facilitating a cardiac death without verifiable coronary stenosis.
CONCLUSIONS: 3-T pmMRI visualizes chronic, subacute, and acute myocardial infarction in situ. In peracute infarction as a possible cause of sudden cardiac death, it demonstrates affected myocardial areas not visible on autopsy. pmMRI should be considered as a feasible post-mortem investigation technique for the deceased patient if no consent for a clinical autopsy is obtained.
Pubmed
Web of science
Open Access
Oui
Création de la notice
20/09/2013 17:24
Dernière modification de la notice
20/08/2019 16:05
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