title: Feasibility of post mortem cardiac proton density weighted fast field echo imaging in two cases of sudden death.
abstract: OBJECTIVE
  The aim of this work is to investigate and compare cardiac proton density (PD) weighted fast field echo (FFE) post-mortem magnetic resonance (PMMR) imaging with standard cardiac PMMR imaging (T1-weighted and T2-weighted turbo spin-echo (TSE)), postmortem CT (PMCT) as well as autopsy.
  
  
  METHODS
  Two human cadavers sequentially underwent cardiac PMCT and PMMR imaging (PD-weighted FFE, T1-weighted and T2-weighted TSE) and autopsy. The cardiac PMMR images were compared to each other as well as to PMCT and autopsy findings.
  
  
  RESULTS
  For the first case, cardiac PMMR exhibited a focal region of low signal in PD-weighted FFE and T2-weighted TSE images, surrounded by a signal intense rim in the T2-weighted images. T1-weighted TSE and PMCT did not appear to identify any focal abnormality. Macroscopic inspection identified a blood clot; histology confirmed this to be a thrombus with an adhering myocardial infarction. In the second case, a myocardial rupture with heart tamponade was identified in all PMMR images, located at the anterior wall of the left ventricle; PMCT excluded additional ruptures. In PD-weighted FFE and T2-weighted TSE images, it occurred hypo-intense, while resulting in small clustered hyper-intense spots in T1-weighted TSE. Autopsy confirmed the PMMR and PMCT findings.
  
  
  CONCLUSIONS
  Presented initial results have shown PD-weighted FFE to be a valuable imaging sequence in addition to traditional T2-weighted TSE imaging for blood clots and myocardial haemorrhage with clearer contrast between affected and healthy myocardium.
authors.affiliation: Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Petersgraben 4, CH-4031 Basel, Switzerland.
authors.forename: Hendrikus J A
authors.initials: HJ
authors.lastname: Crooijmans
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Ruder
authors.forename: Sebastian
authors.initials: S
authors.lastname: Eggert
authors.forename: Pia
authors.initials: P
authors.lastname: Paula
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
authors.forename: Oliver
authors.initials: O
authors.lastname: Bieri
authors.forename: Wolf
authors.initials: W
authors.lastname: Schweitzer
mesh_terms: D000369:Aged, 80 and over; D057791:Cardiac Imaging Techniques / Q000295:instrumentation / Q000379:methods*; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000473:pathology*; D004452:Echocardiography / Q000295:instrumentation / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D049429:Forensic Pathology / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis; D009206:Myocardium / Q000473:pathology; D011522:Protons; D012422:Rupture, Spontaneous / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods
chemical_list: D011522:Protons
keywords: Cardiac imaging; Fast field echo; Forensic radiology; Magnetic resonance imaging; Post-mortem magnetic resonance imaging; Virtopsy