Comparison of conventional autopsy and magnetic resonance imaging in determining the cause of sudden death in the young

Journal of Cardiovascular Magnetic Resonance

Research

Laura Yeates¹  Christopher Semsarian²  Belinda Gray²  Rajesh Puranik³  Helen Lackey⁴  Geoffrey Parker⁵  Johan Duflou⁶ 

[1] Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW, Australia;Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia;Sydney Medical School, University of Sydney, Sydney, NSW, Australia;Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW, Australia;Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia;Sydney Medical School, University of Sydney, Sydney, NSW, Australia;Specialist Magnetic Resonance Imaging, Royal Prince Alfred Hospital Medical Centre, Sydney, NSW, Australia;Specialist Magnetic Resonance Imaging, Royal Prince Alfred Hospital Medical Centre, Sydney, NSW, Australia;Specialist Magnetic Resonance Imaging, Royal Prince Alfred Hospital Medical Centre, Sydney, NSW, Australia;Department of Radiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia;Sydney Medical School, University of Sydney, Sydney, NSW, Australia;Department of Forensic Medicine, Sydney, NSW, Australia;

关键词: Magnetic Resonance Imaging;    Right Ventricular;    Sudden Death;    Arrhythmogenic Right Ventricular Cardiomyopathy;    Computer Tomography Imaging;   

DOI  :  10.1186/1532-429X-16-44

 received in 2014-02-21, accepted in 2014-05-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundSudden death in the young is a tragic complication of a number of medical diseases. There is limited data regarding the utility of post-mortem Magnetic Resonance (MR) imaging and Computer Tomography (CT) scanning in determining the cause of sudden death. This study sought to compare the accuracy of post-mortem cross-sectional imaging (MR and CT) with the conventional autopsy in determining the cause of sudden death in the young.MethodsConsecutive patients from 2010 to 2012 (aged 1–35 years) who had sudden death were included. Patients were scanned by CT and 1.5 T MR imaging prior to the conventional autopsy being performed. The primary outcome was diagnostic congruence between imaging and conventional autopsy.ResultsIn 17 patients studied, the mean age at death was 23 ± 11 years, with a male predominance (n = 12; 71%). The most common cause of death was a primary cardiac pathology (n = 8; 47%), including ARVC (24%) and ischemic heart disease (12%). Non-cardiac causes identified included pulmonary embolism (6%), and aortic dissection (6%). MR imaging correctly identified the diagnosis in 12 patients who subsequently had positive findings at conventional autopsy, while the diagnosis in the remaining 5 cases remained unexplained. MR imaging was found to be highly sensitive (100%) with a high negative (100%) and positive (80%) predictive value.ConclusionsDedicated post-mortem MR imaging of the heart and brain is a useful modality in determining the cause of sudden death in children and young adults, particularly in situations where a conventional autopsy cannot be performed for logistic, cultural or personal reasons.

【 授权许可】

Unknown   
© Puranik et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.