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Postmortem magnetic resonance imaging of the heart ex situ: development of technical protocols

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Abstract

Postmortem MRI (PMMR) examinations are seldom performed in legal medicine due to long examination times, unfamiliarity with the technique, and high costs. Furthermore, it is difficult to obtain access to an MRI device used for patients in clinical settings to image an entire human body. An alternative is available: ex situ organ examination. To our knowledge, there is no standardized protocol that includes ex situ organ preparation and scanning parameters for postmortem MRI. Thus, our objective was to develop a standard procedure for ex situ heart PMMR examinations. We also tested the oily contrast agent Angiofil® commonly used for PMCT angiography, for its applicability in MRI. We worked with a 3 Tesla MRI device and 32-channel head coils. Twelve porcine hearts were used to test different materials to find the best way to prepare and place organs in the device and to test scanning parameters. For coronary MR angiography, we tested different mixtures of Angiofil® and different injection materials. In a second step, 17 human hearts were examined to test the procedure and its applicability to human organs. We established two standardized protocols: one for preparation of the heart and another for scanning parameters based on experience in clinical practice. The established protocols enabled a standardized technical procedure with comparable radiological images, allowing for easy radiological reading. The performance of coronary MR angiography enabled detailed coronary assessment and revealed the utility of Angiofil® as a contrast agent for PMMR. Our simple, reproducible method for performing heart examinations ex situ yields high quality images and visualization of the coronary arteries.

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Acknowledgments

One of the authors (SG) has personal research funding from the Fondation Leenaards, Lausanne, Switzerland.

The contrast agent Angiofil® was provided for this study by the Swiss Company Fumedica AG.

The authors thank Mr Pascal Chèvre, radiographer deputy chief of the MRI unit of the Service of Diagnostic and Interventional Radiology form the University Hospital Lausanne, and Bruno Bonet, radiographer in the Brain Behaviour Laboratory of the University of Geneva, for their appreciated help.

Conflict of interests

None of the authors have any conflicts of interest to declare.

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Authors and Affiliations

  1. University Center of Legal Medicine, Lausanne–Geneva, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland

    C. Bruguier, C. Egger, J. Grimm, P. Mangin & S. Grabherr

  2. Department of Diagnostic and Interventional Radiology, University Hospital Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    C. Bruguier, J. Grimm & X. Boulanger

  3. University Center of Legal Medicine, Lausanne–Geneva, University of Geneva, Rue. Michel-Servet 1, 1211, Geneva 4, Switzerland

    C. Egger & P. Mangin

  4. Department of Radiology, Geneva University Hospitals and University of Geneva, Rue. Grabrielle Perret-Gentil 4, 1205, Geneva, Switzerland

    J. P. Vallée

  5. Center for Forensic Imaging, Institute of Forensic Medicine, University of Bern, Buehlstr. 20, 3012, Bern, Switzerland

    C. Jackowski

Authors
  1. C. Bruguier
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  2. C. Egger
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  3. J. P. Vallée
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  4. J. Grimm
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  5. X. Boulanger
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  6. C. Jackowski
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  7. P. Mangin
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  8. S. Grabherr
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Corresponding author

Correspondence to C. Bruguier.

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Bruguier, C., Egger, C., Vallée, J.P. et al. Postmortem magnetic resonance imaging of the heart ex situ: development of technical protocols. Int J Legal Med 129, 559–567 (2015). https://doi.org/10.1007/s00414-014-1058-1

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  • DOI: https://doi.org/10.1007/s00414-014-1058-1

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