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

作者：Winklhofer Sebastian; Stoeck Christian T; Berger Nicole; Thali Michael; Manka Robert; Kozerke Sebastian; Alkadhi Hatem; Stolzmann Paul^*

来源：European Radiology, 2014, 24(11): 2810-2818.

DOI：10.1007/s00330-014-3322-7

• Magnetic resonance imaging (MeSH)
• Diffusion tensor imaging
• Myocardial infarction
• Ventricular remodelling
• Autopsy

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. %26lt;br%26gt;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. %26lt;br%26gt;Autopsy demonstrated MI in 61/440 segments (13.9 %) in 12/26 deceased subjects. Healthy myocardial segments had significantly higher FA (p %26lt; 0.01) and lower MD (p %26lt; 0.001) compared to segments with MI. Multivariate logistic regression demonstrated that FA (p %26lt; 0.10) and MD (p = 0.01) with the covariate post-mortem time (p %26lt; 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 %26lt; 0.001) but not with acute MI (p %26gt; 0.05). %26lt;br%26gt;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. %26lt;br%26gt;aEuro cent DTI enables post-mortem detection of myocardial infarction with good accuracy. %26lt;br%26gt;aEuro cent A decrease in right-handed helical fibre indicates myofibre remodelling following chronic myocardial infarction. %26lt;br%26gt;aEuro cent DTI allows for ruling out myocardial infarction by means of FA. %26lt;br%26gt;aEuro cent Post-mortem DTI may represent a valuable screening tool in forensic investigations.

• 出版日期2014-11
• 单位ETH, Zurich