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Left myocardial wall measurements on postmortem imaging compared to autopsy


Chatzaraki, Vasiliki; Thali, Michael J; Schweitzer, Wolf; Ampanozi, Garyfalia (2019). Left myocardial wall measurements on postmortem imaging compared to autopsy. Cardiovascular Pathology, 43:107149.

Abstract

Purpose: The aims of this study were, firstly, to determine the relationship of left ventricular wall thickness (LVWT) measurements between postmortem computed tomography (PMCT) and postmortem magnetic resonance imaging (PMMR) and, secondly, to assess the utility of postmortem imaging for LVWT measurements compared to autopsy.
Materials and methods: All cases ≥18 years old, with postmortem interval ≤4 days, cardiac PMCT, PMMR, and full forensic autopsy, were reviewed in our database retrospectively. Exclusion criteria were gas accumulations in the myocardial wall and cardiac trauma. LVWT on PMCT and PMMR was assessed. The measurements were repeated by the same rater after 2 months. Autopsy reports were reviewed, and LVWT and pericardial fluid volume measured at autopsy were noted. Pericardial fluid volume >50 ml was determined positive for pericardial effusion.
Results: A total of 113 cases were included in the study. Twelve cases had pericardial effusion. Intrarater reliability for imaging based LVWT was excellent. LVWT (free wall) was significantly larger on PMCT (18.3 mm) compared to PMMR (17.6 mm), but these measurements correlated positively. LVWT (anterior wall) was significantly larger on PMMR (15 mm) than at autopsy (14 mm), and these measurements also correlated positively. Pericardial effusions led to larger differences between PMMR and autopsy measurements, however without statistical significance.
Discussion: There exist discrepancies between LVWT as measured on postmortem imaging and at autopsy. Specialists should be aware in order to not misinterpret imaging measurements.

Abstract

Purpose: The aims of this study were, firstly, to determine the relationship of left ventricular wall thickness (LVWT) measurements between postmortem computed tomography (PMCT) and postmortem magnetic resonance imaging (PMMR) and, secondly, to assess the utility of postmortem imaging for LVWT measurements compared to autopsy.
Materials and methods: All cases ≥18 years old, with postmortem interval ≤4 days, cardiac PMCT, PMMR, and full forensic autopsy, were reviewed in our database retrospectively. Exclusion criteria were gas accumulations in the myocardial wall and cardiac trauma. LVWT on PMCT and PMMR was assessed. The measurements were repeated by the same rater after 2 months. Autopsy reports were reviewed, and LVWT and pericardial fluid volume measured at autopsy were noted. Pericardial fluid volume >50 ml was determined positive for pericardial effusion.
Results: A total of 113 cases were included in the study. Twelve cases had pericardial effusion. Intrarater reliability for imaging based LVWT was excellent. LVWT (free wall) was significantly larger on PMCT (18.3 mm) compared to PMMR (17.6 mm), but these measurements correlated positively. LVWT (anterior wall) was significantly larger on PMMR (15 mm) than at autopsy (14 mm), and these measurements also correlated positively. Pericardial effusions led to larger differences between PMMR and autopsy measurements, however without statistical significance.
Discussion: There exist discrepancies between LVWT as measured on postmortem imaging and at autopsy. Specialists should be aware in order to not misinterpret imaging measurements.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:510 Mathematics
Scopus Subject Areas:Health Sciences > Pathology and Forensic Medicine
Health Sciences > Cardiology and Cardiovascular Medicine
Uncontrolled Keywords:Pathology and Forensic Medicine, Cardiology and Cardiovascular Medicine, General Medicine
Language:English
Date:1 November 2019
Deposited On:16 Dec 2019 11:20
Last Modified:22 Apr 2020 21:42
Publisher:Elsevier
ISSN:1054-8807
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.carpath.2019.107149
PubMed ID:31639653

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