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CT- und MRT-Befunde an isolierten Leichenherzen

Vergleich der radiologischen mit den pathologisch-anatomischen Befunden

Computed tomography and magnetic resonance imaging compared to pathoanatomic findings in isolated human autopsy hearts

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Zusammenfassung

An 34 isolierten Leichenherzen wurden Computertomographie- (CT-) und Magnetresonanztomographie- (MRT-) Befunde mit pathologisch-anatomischen Befunden und postmortalen Veränderungen verglichen. Innere Totenflecke und postmortale Gerinnselbildungen waren in der MRT, beginnende Fäulnis durch die Darstellung kleiner Gasblasen in der CT gut zu diagnostizieren. Kardiale Verkalkungen der Klappen, der Koronarien und der Papillarmuskeln konnten computertomographisch in ihrem Befallsmuster exakt lokalisiert werden. Ein Septuminfarkt zeigte sich sehr deutlich im T2-gewichteten MR-Bild. Die kollagenen Myokardnarbenareale konnten durch die von ihrer Zusammensetzung abhängigen Kontrastierungen in der T2-Wichtung veranschaulicht werden. Morphologische Veränderungen, wie Hypertrophie und Dilatation, waren sehr deutlich in ihrem Ausmaß auch in der postmortalen Bildgebung zu beurteilen. Die virtuell und real gemessenen Kammerwandstärken stimmten überein. Ein verkalkter Venenbypass mit Thrombosierung war erkennbar. Lediglich eine agonale intramurale Blutung fiel in der primären postmortalen radiologischen Diagnostik aufgrund nur sehr dezenter Kontraste nicht auf. Insgesamt zeigte sich eine sehr gute Übereinstimmung der radiologischen Befunde mit den histologisch bestätigten Sektionsdiagnosen.

Abstract

Computed tomography (CT) and magnetic resonance imaging (MRI) findings obtained from 34 isolated autopsy hearts were compared to pathoanatomic findings and postmortem changes. MRI clearly revealed internal postmortem lividity and postmortem blood clot formation, whereas small gas bubbles demonstrated by CT referred to beginning putrefaction. The pattern of cardiac calcification of the valves, the coronary vessels and papillary muscles could be exactly located by employing CT. The T2-weighted MR image clearly showed a septal infarction. Due to their composition-based contrast, collagenic myocardial scar areas could be demonstrated in T2 weighted images. Morphological changes, such as hypertrophy and dilatation, could be evaluated for both extent and postmortem pattern. The actual ventricular wall thicknesses were identical with those measured. A calcified venous bypass with thromboses was detected. Primary postmortem radiological diagnosis only failed in a case of agonal intramural bleeding which was not detectable due to highly discreet contrast. In general, the radiological findings obtained were in very good correspondence with the histologically confirmed autopsy diagnoses.

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Authors and Affiliations

  1. Institut für Rechtsmedizin, Universität Magdeburg

    K. Jachau, W. Kuchheuser, D. Krause, H. Wittig, R. Schöning, N. Beck & C. Jackowski

  2. Klinik für Diagnostische Radiologie, Universität Magdeburg

    T. Heinrichs, O. Beuing & W. Döhring

  3. Institut für Rechtsmedizin, Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg

    K. Jachau

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  1. K. Jachau
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  2. T. Heinrichs
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  10. C. Jackowski
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Correspondence to K. Jachau.

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Jachau, K., Heinrichs, T., Kuchheuser, W. et al. CT- und MRT-Befunde an isolierten Leichenherzen. Rechtsmedizin 14, 109–116 (2004). https://doi.org/10.1007/s00194-004-0252-8

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  • DOI: https://doi.org/10.1007/s00194-004-0252-8

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