| 1. |
- Bonzon, Jerome, et al.
(author)
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Rigor mortis at the myocardium investigated by post-mortem magnetic resonance imaging
- 2015
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In: Forensic Science International. - : ELSEVIER IRELAND LTD. - 0379-0738 .- 1872-6283. ; 257, s. 93-97
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Journal article (peer-reviewed)abstract
- Introduction: Post-mortem cardiac MR exams present with different contraction appearances of the left ventricle in cardiac short axis images. It was hypothesized that the grade of post-mortem contraction may be related to the post-mortem interval (PMI) or cause of death and a phenomenon caused by internal rigor mortis that may give further insights in the circumstances of death. Method and materials: The cardiac contraction grade was investigated in 71 post-mortem cardiac MR exams (mean age at death 52 y, range 12-89 y; 48 males, 23 females). In cardiac short axis images the left ventricular lumen volume as well as the left ventricular myocardial volume were assessed by manual segmentation. The quotient of both (LVQ) represents the grade of myocardial contraction. LVQ was correlated to the PMI, sex, age, cardiac weight, body mass and height, cause of death and pericardial tamponade when present. In cardiac causes of death a separate correlation was investigated for acute myocardial infarction cases and arrhythmic deaths. Results: LVQ values ranged from 1.99 (maximum dilatation) to 42.91 (maximum contraction) with a mean of 15.13. LVQ decreased slightly with increasing PMI, however without significant correlation. Pericardial tamponade positively correlated with higher LVQ values. Variables such as sex, age, body mass and height, cardiac weight and cause of death did not correlate with LVQ values. There was no difference in LVQ values for myocardial infarction without tamponade and arrhythmic deaths. Conclusion: Based on the observation in our investigated cases, the phenomenon of post-mortem myocardial contraction cannot be explained by the influence of the investigated variables, except for pericardial tamponade cases. Further research addressing post-mortem myocardial contraction has to focus on other, less obvious factors, which may influence the early post-mortem phase too. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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| 2. |
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| 3. |
- Jackowski, Christian, 1975-, et al.
(author)
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Magnetic resonance imaging goes postmortem: noninvasive detection and assessment of myocardial infarction by postmortem MRI
- 2011
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In: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; Jan;21:1, s. 70-78
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the performance of postmortem magnetic resonance imaging (pmMRI) in identification and characterization of lethal myocardial infarction in a non-invasive manner on human corpses.MATERIALS AND METHODS: Before forensic autopsy, 20 human forensic corpses were examined on a 1.5-T system for the presence of myocardial infarction. Short axis, transversal and longitudinal long axis images (T1-weighted; T2-weighted; PD-weighted) were acquired in situ. In subsequent autopsy, the section technique was adapted to short axis images. Histological investigations were conducted to confirm autopsy and/or radiological diagnoses.RESULTS: Nineteen myocardial lesions were detected and age staged with pmMRI, of which 13 were histologically confirmed (chronic, subacute and acute). Six lesions interpreted as peracute by pmMRI showed no macroscopic or histological finding. Five of the six peracute lesions correlated well to coronary pathology, and one case displayed a severe hypertrophic alteration.CONCLUSION: pmMRI reliably demonstrates chronic, subacute and acute myocardial infarction in situ. In peracute cases pmMRI may display ischemic lesions undetectable at autopsy and routine histology. pmMRI has the potential to substantiate autopsy and to counteract the loss of reliable information on causes of death due to the recent disappearance of the clinical autopsy.
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| 4. |
- Jackowski, Christian, et al.
(author)
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Post-Mortem Cardiac 3-T Magnetic Resonance Imaging Visualization of Sudden Cardiac Death?
- 2013
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In: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 62:7, s. 617-629
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Journal article (peer-reviewed)abstract
- Objectives This study aimed to investigate post-mortem magnetic resonance imaging (pmMRI) for the assessment of myocardial infarction and hypointensities on post-mortem T-2-weighted images as a possible method for visualizing the myocardial origin of arrhythmic sudden cardiac death. less thanbrgreater than less thanbrgreater thanBackground Sudden cardiac death has challenged clinical and forensic pathologists for decades because verification on post-mortem autopsy is not possible. pmMRI as an autopsy-supporting examination technique has been shown to visualize different stages of myocardial infarction. less thanbrgreater than less thanbrgreater thanMethods In 136 human forensic corpses, a post-mortem cardiac MR examination was carried out prior to forensic autopsy. Short-axis and horizontal long-axis images were acquired in situ on a 3-T system. less thanbrgreater than less thanbrgreater thanResults In 76 cases, myocardial findings could be documented and correlated to the autopsy findings. Within these 76 study cases, a total of 124 myocardial lesions were detected on pmMRI (chronic: 25; subacute: 16; acute: 30; and peracute: 53). Chronic, subacute, and acute infarction cases correlated excellently to the myocardial findings on autopsy. Peracute infarctions (age range: minutes to approximately 1 h) were not visible on macroscopic autopsy or histological examination. Peracute infarction areas detected on pmMRI could be verified in targeted histological investigations in 62.3% of cases and could be related to a matching coronary finding in 84.9%. A total of 15.1% of peracute lesions on pmMRI lacked a matching coronary finding but presented with severe myocardial hypertrophy or cocaine intoxication facilitating a cardiac death without verifiable coronary stenosis. less thanbrgreater than less thanbrgreater thanConclusions 3-T pmMRI visualizes chronic, subacute, and acute myocardial infarction in situ. In peracute infarction as a possible cause of sudden cardiac death, it demonstrates affected myocardial areas not visible on autopsy. pmMRI should be considered as a feasible post-mortem investigation technique for the deceased patient if no consent for a clinical autopsy is obtained.
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| 5. |
- Jackowski, Christian, 1975-, et al.
(author)
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Quantitative MRI in Isotropic Spatial Resolution for Forensic Soft Tissue Documentation. Why and How?
- 2011
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In: Journal of Forensic Sciences. - : Blackwell. - 0022-1198 .- 1556-4029. ; 56:1, s. 208-215
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Journal article (peer-reviewed)abstract
- A quantification of T1, T2, and PD in high isotropic resolution was performed on corpses. Isotropic and quantified postmortem magnetic resonance (IQpmMR) enables sophisticated 3D postprocessing, such as reformatting and volume rendering. The body tissues can be characterized by the combination of these three values. The values of T1, T2, and PD were given as coordinates in a T1-T2-PD space where similar tissue voxels formed clusters. Implementing in a volume rendering software enabled color encoding of specific tissues and pathologies in 3D models of the corpse similar to computed tomography, but with distinctively more powerful soft tissue discrimination. From IQpmMR data, any image plane at any contrast weighting may be calculated or 3D color-encoded volume rendering may be carried out. The introduced approach will enable future computer-aided diagnosis that, e.g., checks corpses for a hemorrhage distribution based on the knowledge of its T1-T2-PD vector behavior in a high spatial resolution.
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| 6. |
- Jackowski, Christian, et al.
(author)
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Scenes from the past - Common and unexpected findings in mummies from ancient Egypt and South America as revealed by CT
- 2008
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In: Radiographics. - : Radiological Society of North America (RSNA). - 0271-5333 .- 1527-1323. ; 28:5, s. 1477-1492
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Journal article (peer-reviewed)abstract
- Computed tomography (CT) has proved to be a valuable investigative tool for mummy research and is the method of choice for examining mummies. It allows for noninvasive insight, especially with virtual endoscopy, which reveals detailed information about the mummy's sex, age, constitution, injuries, health, and mummification techniques used. CT also supplies three-dimensional information about the scanned object. Mummification processes can be summarized as "artificial," when the procedure was performed on a body with the aim of preservation, or as "natural," when the body's natural environment resulted in preservation. The purpose of artificial mummification was to preserve that person's morphologic features by delaying or arresting the decay of the body. The ancient Egyptians are most famous for this. Their use of evisceration followed by desiccation with natron (a compound of sodium salts) to halt putrefaction and prevent rehydration was so effective that their embalmed bodies have survived for nearly 4500 years. First, the body was cleaned with a natron solution, then internal organs were removed through the cribriform plate and abdomen. The most important, and probably the most lengthy, phase was desiccation. After the body was dehydrated, the body cavities were rinsed and packed to restore the body's former shape. Finally, the body was wrapped. Animals were also mummified to provide food for the deceased, to accompany the deceased as pets, because they were seen as corporal manifestations of deities, and as votive offerings. Artificial mummification was performed on every continent, especially in South and Central America. (C) RSNA, 2008 . radiographics.rsnajnls.org.
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| 7. |
- Jackowski, Christian, et al.
(author)
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Whole body postmortem angiography with a high viscosity contrast agent solution using poly ethylene glycol as contrast agent dissolver
- 2008
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In: Journal of Forensic Sciences. - : Blackwell Publishing. - 0022-1198 .- 1556-4029. ; 53:2, s. 465-468
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Journal article (peer-reviewed)abstract
- Postmortem minimal invasive angiography has already been implemented to support virtual autopsy examinations. An experimental approach in a porcine model to overcome an initially described artificial tissue edema artifact by using a poly ethylene glycol (PEG) containing contrast agent solution showed promising results. The present publication describes the first application of PEG in a whole corpse angiographic CT examination. A minimal invasive postmortem CT angiography was performed in a human corpse utilizing the high viscosity contrast agent solution containing 65% of PEG. Injection was carried out via the femoral artery into the aortic root in simulated cardiac output conditions. Subsequent CT scanning delivered the 3D volume data of the whole corpse. Visualization of the human arterial anatomy was excellent and the contrast agent distribution was generally limited to the arterial system as intended. As exceptions an enhancement of the brain, the left ventricular myocardium and the renal cortex became obvious. This most likely represented the stage of centralization of the blood circulation at the time of death with dilatation of the precapillary arterioles within these tissues. Especially for the brain this resulted in a distinctively improved visualization of the intracerebral structures by CT. However, the general tissue edema artifact of postmortem minimal invasive angiography examinations could be distinctively reduced. © 2008 American Academy of Forensic Sciences.
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| 8. |
- Norrlid, Lilian del Risco, et al.
(author)
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Imaging of small children prototype for photon counting tomosynthesis
- 2009
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In: Medical Imaging 2009. - : SPIE-Intl Soc Optical Eng.
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Conference paper (peer-reviewed)abstract
- We present data on a first prototype for photon counting tomosynthesis imaging of small children, which we call photoncounting tomosynthesis (PCT). A photon counting detector can completely eliminate electronic noise, which makes it ideal for tomosynthesis because of the low dose in each projection. Another advantage is that the detector allows for energy sensitivity in later versions, which will further lower the radiation dose. In-plane resolution is high and has been measured to be 5lp/mm, at least 4 times better than in CT, while the depth resolution was significantly lower than typical CT resolution. The image SNR decreased from 30 to 10 for a detail of 10 mm depth in increasing thickness of PMMA from 10 to 80 mm. The air kerma measured for PCT was 5.2 mGy, which leads to an organ dose to the brain of approximately 0.7 mGy. This dose is 96 % lower than a typical CT dose. PCT can be appealing for pediatric imaging since young children have an increased sensitivity to radiation induced cancers. We have acquired post mortem images of a newborn with the new device and with a state-of-the-art CT and compared the diagnostic information and dose levels of the two modalities. The results are promising but more work is needed to provide input to a next generation prototype that would be suitable for clinical trials.
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| 9. |
- Persson, Anders, 1953-, et al.
(author)
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A state-of-the-art pipeline for postmortem CT and MRI visualization: from data acquisition to interactive image interpretation at autopsy
- 2011
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In: Acta Radiologica. - London, United Kingdom : Sage Publications. - 0284-1851 .- 1600-0455. ; 52:5, s. 522-536
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Research review (peer-reviewed)abstract
- The importance of autopsy procedures leading to the establishment of the cause of death is well-known. A recent addition to the autopsy work flow is the possibility of conducting postmortem imaging, in its 3D version also called virtual autopsy (VA), using multidetector computed tomography (MDCT) or magnetic resonance imagining (MRI) data from scans of cadavers displayed with direct volume rendering (DVR) 3D techniques. The use of the data and their workflow are presented. Data acquisition was performed and high quality data-sets with submillimeter precision were acquired. New data acquisition techniques such as dualenergy CT (DECT) and quantitative MRI, then were implemented and provided additional information. Particular findings hardly visualized in conventional autopsy can rather easy be seen at the full body CT, such as air distribution, e.g. pneumothorax, pneumopericardium, air embolism, and wound channels. MRI shows natural deaths such as myocardial infarctions. Interactive visualization of these 3D data-sets can provide valuable insight into the corpses and enables non-invasive diagnostic procedures. In postmortem CT imaging, not being limited by a patient depending radiation dose limit the data-sets can, however, be generated with such a high resolution that they become difficult to handle in today’s archive retrieval and interactive visualization systems, specifically in the case of full body scans. To take full advantage of these new technologies the postmortem workflow needs to be tailored to the demands and opportunities that the new technologies allow.
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| 10. |
- Persson, Anders, 1953-, et al.
(author)
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Advances of dual source, dual-energy imaging in postmortem CT
- 2008
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In: European Journal of Radiology. - : Elsevier BV. - 0720-048X .- 1872-7727. ; 68:3, s. 446-455
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Journal article (peer-reviewed)abstract
- This paper focuses on the use of multi-detector row dual-energy computed tomography (DECT) in the evaluation of postmortal examinations. The use of dual energy moves postmortem CT to an entirely new dimension of diagnostic sensitivity where contrast in the image is not merely limited to X-ray attenuation differences, but may include elements of functional and tissue characterization. This additional information may be used to improve the benefit postmortem imaging can provide to supplement and simplify the conventional autopsy. © 2008 Elsevier Ireland Ltd. All rights reserved.
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