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01-03-2018 | Method Paper

Postmortem ¹H-MRS—Detection of Ketone Bodies and Glucose in Diabetic Ketoacidosis

Authors: Jakob Heimer, Dominic Gascho, Vasiliki Chatzaraki, Damaris Fröhlich Knaute, Vera Sterzik, Rosa Maria Martinez, Michael J. Thali, Niklaus Zoelch

Published in: International Journal of Legal Medicine | Issue 2/2018

Abstract

Diabetic ketoacidosis (DKA) is a metabolic complication of diabetes mellitus that takes a lethal course if untreated. In this way relevant to forensic medicine, secure diagnosis of DKA usually involves the evidence of elevated levels of glucose and the ketone bodies acetone, acetoacetate, and β-hydroxybutyrate in corpse fluids. We conducted a postmortem hydrogen proton magnetic resonance spectroscopy (¹H-MRS) in a case of lethal DKA. Distinctive resonances of all three ketone bodies as well as glucose were visible in spectra of cerebrospinal fluid, vitreous humor, and white matter. Estimated concentrations of ketone bodies and glucose supported the findings both of autopsy and biochemical analysis. Advantages of human postmortem ¹H-MRS are the lack of movement and flow artifacts as well as lesser limitations of scan duration. Postmortem ¹H-MRS is able to non-invasively measure concentrations of glucose and ketone bodies in small volumes of various regions of the brain. It may thus become a diagnostic tool for forensic investigations by quick determination of pathological metabolite concentrations in addition to conventional autopsy.

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Title: Postmortem 1H-MRS—Detection of Ketone Bodies and Glucose in Diabetic Ketoacidosis
Authors: Jakob Heimer
Dominic Gascho
Vasiliki Chatzaraki
Damaris Fröhlich Knaute
Vera Sterzik
Rosa Maria Martinez
Michael J. Thali
Niklaus Zoelch
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Legal Medicine / Issue 2/2018
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-017-1741-0

At a glance: The STEP trials

Springer Medicine

Postmortem ¹H-MRS—Detection of Ketone Bodies and Glucose in Diabetic Ketoacidosis

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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