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T2 and T2∗ mapping in ex situ porcine myocardium: myocardial intravariability, temporal stability and the effects of complete coronary occlusion

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Abstract

Diagnosis of ischaemia-related sudden cardiac death in the absence of microscopic and macroscopic ischaemic lesions remains a challenge for medical examiners. Medical imaging techniques increasingly provide support in post-mortem examinations by detecting and documenting internal findings prior to autopsy. Previous studies have characterised MR relaxation times to investigate post-mortem signs of myocardial infarction in forensic cohorts. In this prospective study based on an ex situ porcine heart model, we report fundamental findings related to intramyocardial variability and temporal stability of T2 as well as the effects of permanent coronary occlusion on T2 and T2∗ relaxation in post-mortem myocardium. The ex situ porcine hearts included in this study (n= 19) were examined in two groups (Ss, n= 11 and Si, n= 8). All magnetic resonance imaging (MRI) examinations were performed ex situ, at room temperature and at 3 T. In the Ss group, T2 mapping was performed on slaughterhouse porcine hearts at different post-mortem intervals (PMI) between 7 and 26 h. Regarding the intramyocardial variability, no statistically significant differences in T2 were observed between myocardial segments (p= 0.167). Assessment of temporal stability indicated a weak negative correlation (r=− 0.21) between myocardial T2 and PMI. In the Si group, animals underwent ethanol-induced complete occlusion of the left anterior descending artery. T2 and T2∗ mapping were performed within 3 h of death. Differences between the expected ischaemic and remote regions were statistically significant for T2 (p= 0.007), however not for T2∗ (p= 0.062). Our results provide important information for future assessment of the diagnostic potential of quantitative MRI in the post-mortem detection of early acute myocardial infarction.

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Funding

Bridgette Webb is a recipient of a DOC Fellowship of the Austrian Academy of Sciences at the Ludwig Boltzmann Institute for Clinical Forensic Imaging, Graz, Austria.

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Authors and Affiliations

  1. Ludwig Boltzmann Institute for Clinical Forensic Imaging, Graz, Austria

    Bridgette Webb, Thomas Widek & Thorsten Schwark

  2. BioTechMed, Graz, Austria

    Bridgette Webb, Thomas Widek & Rudolf Stollberger

  3. Division of Cardiology, Department of Medicine, Medical University of Graz, Graz, Austria

    Martin Manninger, Martin Dobrovnik & Daniel Scherr

  4. Institute of Pathology, Medical University of Graz, Graz, Austria

    Marlene Leoni

  5. Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands

    Daniel Scherr

  6. Institute of Medical Engineering, Graz University of Technology, Graz, Austria

    Rudolf Stollberger

  7. Institute of Forensic Medicine, Medical University Graz, Graz, Austria

    Thorsten Schwark

  8. Laboratoire National de Santé, Dudelange, Luxembourg

    Thorsten Schwark

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  1. Bridgette Webb
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Webb, B., Manninger, M., Leoni, M. et al. T2 and T2∗ mapping in ex situ porcine myocardium: myocardial intravariability, temporal stability and the effects of complete coronary occlusion. Int J Legal Med 134, 679–690 (2020). https://doi.org/10.1007/s00414-019-02211-0

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