Postmortem imaging of antemortem myocardial ischaemia

作者：Pluchinotta Francesca R; Porayette Prashob; Myers Patrick O; Chen Peter; Feins Eric; Teot Lisa; Prabhu Sanjay P; Sanders Stephen P^*

来源：European Radiology, 2014, 24(1): 34-41.

DOI：10.1007/s00330-013-2974-z

• Myocardial ischaemia
• Postmortem Imaging
• Magnetic resonance
• Computed tomography
• Animal model

Objectives To determine the minimum survival time for detection of antemortem myocardial ischaemia with postmortem imaging (PMI) techniques.
Methods Nine pigs underwent ligation of the left anterior descending (LAD) (8) and/or right coronary artery (RCA) branch (4), and were killed 30 min-6 h after ligation. PMI (MRI and CT angiography) was performed 2-55 h after euthanasia. Signal intensity of myocardial segments was measured. The hearts were removed, the coronary arteries injected to mark perfused segments, and sections submitted for histology.
Results MRI T2-weighted sequences showed the ischaemic area as hyperintense in 4/4 LAD ligations with >= 4 h of ischaemia but in 0/4 with < 4 h. Histological evidence of ischaemia was present in 4/4 animals after 4 h. Right ventricular ischaemic myocardium was visible on MRI T2-weighted sequences after 6 h of ischaemia in one animal. CT angiography showed the occluded coronary artery in all cases.
Conclusions Ischaemic lesions of the left ventricle, but not of the right, at least 4 h old can be detected as hyperintense areas on T2-weighted postmortem MRI. This technique is most sensitive in the first 24 h after death. Other sequences did not enhance detection.
Key Points
Left ventricular myocardial ischaemia/infarction can be demonstrated by postmortem imaging (PMI).
Ischaemia/infarction is better detected if survival time is at least 4 h.
Right ventricular ischaemia/infarction is not reliably detected by PMI.
Computed tomography angiography can demonstrate arterial occlusion.

• 出版日期2014-1