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


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.


CONCLUSIONS
Postmortem MRI demonstrates myocardial infarction in situ and allows for an infarction age estimation based on the signal behaviour.
Jackowski
Christian
C
Centre of Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, IRM-Bühlstrasse 20, CH-3012 Bern, Switzerland. christian.jackowski@irm.unibe.ch
Christe
Andreas
A
Sonnenschein
Martin
M
Aghayev
Emin
E
Thali
Michael J
MJ
D000208:Acute Disease; D000368:Aged; D001344:Autopsy / Q000379:methods / Q000592:standards; D002908:Chronic Disease; D003198:Computer Simulation; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*