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Postmortem MR quantification of the heart for characterization and differentiation of ischaemic myocardial lesions

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Recently, an MRI quantification sequence has been developed which can be used to acquire T1- and T2-relaxation times as well as proton density (PD) values. Those three quantitative values can be used to describe soft tissue in an objective manner. The purpose of this study was to investigate the applicability of quantitative cardiac MRI for characterization and differentiation of ischaemic myocardial lesions of different age.

Materials and methods

Fifty post-mortem short axis cardiac 3 T MR examinations have been quantified using a quantification sequence. Myocardial lesions were identified according to histology and appearance in MRI images. Ischaemic lesions were assessed for mean T1-, T2- and proton density values. Quantitative values were plotted in a 3D-coordinate system to investigate the clustering of ischaemic myocardial lesions.

Results

A total of 16 myocardial lesions detected in MRI images were histologically characterized as acute lesions (n = 8) with perifocal oedema (n = 8), subacute lesions (n = 6) and chronic lesions (n = 2). In a 3D plot comprising the combined quantitative values of T1, T2 and PD, the clusters of all investigated lesions could be well differentiated from each other.

Conclusion

Post-mortem quantitative cardiac MRI is feasible for characterization and discrimination of different age stages of myocardial infarction.

Key Points

• MR quantification is feasible for characterization of different stages of myocardial infarction.

• The results provide the base for computer-aided MRI cardiac infarction diagnosis.

• Diagnostic criteria may also be applied for living patients.

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Abbreviations

MRI:

magnetic resonance imaging

pm MRI:

post mortem resonance imaging

T:

Tesla

T2w:

T2-weighted

PD:

proton density

TR:

repetition time

TE:

echo time

ROI:

region of interest

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Acknowledgements

The scientific guarantor of this publication is Prof. Christian Jackowski MD, Head of Departement Institute of Forensic Medicine Bern, Switzerland. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Beat Kneubuehl, PhD, kindly provided statistical advice for this manuscript. Institutional Review Board approval was not required because all cases/corpses were investigated by order of the local prosecutors. The prosecutors agreed to research on corpses when the personal data of the deceased persons are treated strictly confidential. Since we treat all personal data of corpses as confidential we have information from the Institutional Review Board that approval from the Review Board is not necessary for all our conducted post-mortem studies including post-mortem imaging. Written informed consent was not required for this study because the subjects studied were deceased persons. None of the study subjects or cohorts have been previously reported. Methodology: prospective, experimental, performed at one institution.

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Authors and Affiliations

  1. Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012, Bern, Switzerland

    Wolf-Dieter Zech, Nicole Schwendener & Christian Jackowski

  2. Center for Medical Image Science and Visualization (CMIV), University of Linköping, 58185, Linköping, Sweden

    Anders Persson & Marcel J. Warntjes

Authors
  1. Wolf-Dieter Zech
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  2. Nicole Schwendener
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  3. Anders Persson
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  4. Marcel J. Warntjes
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  5. Christian Jackowski
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Correspondence to Wolf-Dieter Zech.

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Zech, WD., Schwendener, N., Persson, A. et al. Postmortem MR quantification of the heart for characterization and differentiation of ischaemic myocardial lesions. Eur Radiol 25, 2067–2073 (2015). https://doi.org/10.1007/s00330-014-3582-2

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  • DOI: https://doi.org/10.1007/s00330-014-3582-2

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