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

Winklhofer, Sebastian ; Stoeck, Christian ; Berger, Nicole ; Thali, Michael ; Manka, Robert ; Kozerke, Sebastian ; Alkadhi, Hatem ; Stolzmann, Paul

In: European Radiology, 2014, vol. 24, no. 11, p. 2810-2818

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    Titre
    • Post-mortem cardiac diffusion tensor imaging: detection of myocardial infarction and remodeling of myofiber architecture
    Auteur
    • Winklhofer, Sebastian. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Stoeck, Christian. Institute for Biomedical Engineering University and ETH Zurich, Zurich, Switzerland
    • Berger, Nicole. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Thali, Michael. Department of Forensic Medicine and Radiology, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
    • Manka, Robert. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Kozerke, Sebastian. Institute for Biomedical Engineering University and ETH Zurich, Zurich, Switzerland
    • Alkadhi, Hatem. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Stolzmann, Paul. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Radiology, 2014, vol. 24, no. 11, p. 2810-2818. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:325391
    Summary
    Objectives: 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. Methods: 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. Results: Autopsy demonstrated MI in 61/440 segments (13.9%) in 12/26 deceased subjects. Healthy myocardial segments had significantly higher FA (p < 0.01) and lower MD (p < 0.001) compared to segments with MI. Multivariate logistic regression demonstrated that FA (p < 0.10) and MD (p = 0.01) with the covariate post-mortem time (p < 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 < 0.001) but not with acute MI (p > 0.05). Conclusions: 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. Key Points : • DTI enables post-mortem detection of myocardial infarction with good accuracy. • A decrease in right-handed helical fibre indicates myofibre remodelling following chronic myocardial infarction. • DTI allows for ruling out myocardial infarction by means of FA. • Post-mortem DTI may represent a valuable screening tool in forensic investigations.