Post-Mortem Cardiac 3-T Magnetic Resonance Imaging Visualization of Sudden Cardiac Death?
2013 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 62, no 7, 617-629 p.Article in journal (Refereed) Published
Objectives This study aimed to investigate post-mortem magnetic resonance imaging (pmMRI) for the assessment of myocardial infarction and hypointensities on post-mortem T-2-weighted images as a possible method for visualizing the myocardial origin of arrhythmic sudden cardiac death. less thanbrgreater than less thanbrgreater thanBackground 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. less thanbrgreater than less thanbrgreater thanMethods 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. less thanbrgreater than less thanbrgreater thanResults 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. less thanbrgreater than less thanbrgreater thanConclusions 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.
Place, publisher, year, edition, pages
Elsevier , 2013. Vol. 62, no 7, 617-629 p.
myocardial infarction, post-mortem cardiac imaging, post-mortem magnetic resonance imaging
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-97665DOI: 10.1016/j.jacc.2013.01.089ISI: 000323605200009OAI: oai:DiVA.org:liu-97665DiVA: diva2:649981
Funding Agencies|Philips AG Healthcare, Zurich, Switzerland||2013-09-192013-09-192013-10-21