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01.11.2014 | Forensic Medicine

Post-mortem cardiac diffusion tensor imaging: detection of myocardial infarction and remodeling of myofiber architecture

verfasst von: Sebastian Winklhofer, Christian T. Stoeck, Nicole Berger, Michael Thali, Robert Manka, Sebastian Kozerke, Hatem Alkadhi, Paul Stolzmann

Erschienen in: European Radiology | Ausgabe 11/2014

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Abstract

Objectives

To investigate the accuracy of post-mortem diffusion tensor imaging (DTI) for the detection of myocardial infarction (MI) and to demonstrate the feasibility of helix angle (HA) calculation to study remodelling of myofibre architecture.

Methods

Cardiac DTI was performed in 26 deceased subjects prior to autopsy for medicolegal reasons. Fractional anisotropy (FA) and mean diffusivity (MD) were determined. Accuracy was calculated on per-segment (AHA classification), per-territory, and per-patient basis, with pathology as reference standard. HAs were calculated and compared between healthy segments and those with MI.

Results

Autopsy demonstrated MI in 61/440 segments (13.9 %) in 12/26 deceased subjects. Healthy myocardial segments had significantly higher FA (p < 0.01) and lower MD (p < 0.001) compared to segments with MI. Multivariate logistic regression demonstrated that FA (p < 0.10) and MD (p = 0.01) with the covariate post-mortem time (p < 0.01) predicted MI with an accuracy of 0.73. Analysis of HA distribution demonstrated remodelling of myofibre architecture, with significant differences between healthy segments and segments with chronic (p < 0.001) but not with acute MI (p > 0.05).

Conclusions

Post-mortem cardiac DTI enablesdifferentiation between healthy and infarcted myocardial segments by means of FA and MD. HA assessment allows for the demonstration of remodelling of myofibre architecture following chronic MI.

Key Points

• DTI enables post-mortem detection of myocardial infarction with good accuracy.

• A decrease in right-handed helical fibre indicates myofibre remodelling following chronic myocardial infarction.

• DTI allows for ruling out myocardial infarction by means of FA.

• Post-mortem DTI may represent a valuable screening tool in forensic investigations.

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Titel: Post-mortem cardiac diffusion tensor imaging: detection of myocardial infarction and remodeling of myofiber architecture
verfasst von: Sebastian Winklhofer
Christian T. Stoeck
Nicole Berger
Michael Thali
Robert Manka
Sebastian Kozerke
Hatem Alkadhi
Paul Stolzmann
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3322-7

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Post-mortem cardiac diffusion tensor imaging: detection of myocardial infarction and remodeling of myofiber architecture

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Abstract

Objectives

Methods

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Conclusions

Key Points

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