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European Heart Journal Advance Access originally published online on September 14, 2006
European Heart Journal 2006 27(20):2459-2467; doi:10.1093/eurheartj/ehl255
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Postmortem unenhanced magnetic resonance imaging of myocardial infarction in correlation to histological infarction age characterization

Christian Jackowski1,*, Andreas Christe1,2, Martin Sonnenschein3, Emin Aghayev1 and Michael J. Thali1

1 Centre of Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, IRM—Bühlstrasse 20, CH-3012 Bern, Switzerland
2 Institute of Diagnostic Radiology, Inselspital, University of Bern, 3010 Bern, Switzerland
3 Department of Diagnostic Radiology, Sonnenhof Spital AG, Buchserstrasse 30, 3006 Bern, Switzerland

Received 13 April 2006; revised 6 August 2006; accepted 31 August 2006; online publish-ahead-of-print 14 September 2006.

* Corresponding author. Tel: +41 316318412; fax: +41 316313833. E-mail address: christian.jackowski{at}irm.unibe.ch

Aims Postmortem magnetic resonance (MRI) imaging is currently evaluated as alternative to traditional autopsy and myocardial infarction plays a key role therein. The aim of this study is to determine the suitability of postmortem MRI in infarction age staging.

Methods and results In eight human forensic corpses presenting with a total of 11 myocardial infarcted areas, short-axis, transversal, and longitudinal long-axis images (T1, T2, stir, flair) were acquired in situ on a 1.5 T system. During subsequent autopsy, the section technique was adapted to short-axis images. Histological investigations were performed along the entire circumference of the left ventricle to correlate the signal alteration in MR to the histological appearance. Two peracute infarctions were not detected in MRI and autopsy. Four acute infarcted areas presented with decreased signal in necrotic centres and increased signal in marginal myocardial regions (T2-weighted). T1-weighted images showed local hyperintensities when intramyocardial haemorrhage occurred. Four cases showed subacute infarctions with hyperintense regions in T2-weighted images and no signal alteration in T1-weighted images. Four chronic myocardial infarctions showed distinctively decreased signals in all applied sequences.

Conclusion Postmortem MRI demonstrates myocardial infarction in situ and allows for an infarction age estimation based on the signal behaviour.

Key Words: Virtopsy • Magnetic resonance imaging • Postmortem cardiac imaging • Myocardial infarction • Virtual autopsy


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