ABSTRACT
Postmortem MRI (PMMR) examinations are seldom performed in legal medicine due to long examination times, unfamiliarity with the technique, and high costs. Furthermore, it is difficult to obtain access to an MRI device used for patients in clinical settings to image an entire human body. An alternative is available: ex situ organ examination. To our knowledge, there is no standardized protocol that includes ex situ organ preparation and scanning parameters for postmortem MRI. Thus, our objective was to develop a standard procedure for ex situ heart PMMR examinations. We also tested the oily contrast agent Angiofil® commonly used for PMCT angiography, for its applicability in MRI. We worked with a 3 Tesla MRI device and 32-channel head coils. Twelve porcine hearts were used to test different materials to find the best way to prepare and place organs in the device and to test scanning parameters. For coronary MR angiography, we tested different mixtures of Angiofil® and different injection materials. In a second step, 17 human hearts were examined to test the procedure and its applicability to human organs. We established two standardized protocols: one for preparation of the heart and another for scanning parameters based on experience in clinical practice. The established protocols enabled a standardized technical procedure with comparable radiological images, allowing for easy radiological reading. The performance of coronary MR angiography enabled detailed coronary assessment and revealed the utility of Angiofil® as a contrast agent for PMMR. Our simple, reproducible method for performing heart examinations ex situ yields high quality images and visualization of the coronary arteries.
Subject(s)
Autopsy/methods , Coronary Vessels/pathology , Heart , Magnetic Resonance Imaging/methods , Myocardium/pathology , Animals , Contrast Media , Coronary Angiography/methods , In Vitro Techniques , Magnetic Resonance Angiography/methods , SwineABSTRACT
The first line imaging of the non-traumatic brachial plexus is by MRI. Knowledge of the anatomy and commonest variants is essential. Three Tesla imaging offers the possibility of 3D isotropic sequences with excellent spatial and contrast enhancement resolutions, which leads to time saving and quality boosting. The most commonly seen conditions are benign tumor lesions and radiation damage. Gadolinium is required to assess inflammatory or tumour plexopathy. MRI data should be correlated with FDG-PET if tumor recurrence is suspected.
Subject(s)
Brachial Plexus Neuropathies/diagnosis , Brachial Plexus/pathology , Fluorodeoxyglucose F18 , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging/methods , Peripheral Nervous System Neoplasms/diagnosis , Positron-Emission Tomography/methods , Brachial Plexus/injuries , Brachial Plexus/radiation effects , Brachial Plexus Neuropathies/pathology , Diagnosis, Differential , Humans , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Nerve Compression Syndromes/diagnosis , Nerve Compression Syndromes/pathology , Neurilemmoma/diagnosis , Neurilemmoma/pathology , Neurofibroma/diagnosis , Neurofibroma/pathology , Neurologic Examination , Peripheral Nervous System Neoplasms/pathology , Radiation Injuries/diagnosis , Radiation Injuries/pathology , Reference Values , Sensitivity and Specificity , Syndrome , Thoracic Outlet Syndrome/diagnosis , Thoracic Outlet Syndrome/pathologySubject(s)
Bezoars/diagnostic imaging , Ileal Diseases/diagnostic imaging , Intestinal Obstruction/diagnostic imaging , Narcotics , Tomography, X-Ray Computed/methods , Adult , Bezoars/diagnosis , Bezoars/surgery , Diagnosis, Differential , Drug Implants , Female , Humans , Ileal Diseases/diagnosis , Ileal Diseases/surgery , Intestinal Obstruction/diagnosis , Intestinal Obstruction/surgery , Laparotomy/methods , Pisum sativum , Risk AssessmentABSTRACT
PURPOSE: To determine the performance of a CAD system for lung nodules with ground glass opacity component on multidetector-row CT. Materials and methods. The CT examinations of 17 patients with at least one persistent subsolid nodule were reviewed. A first non-blinded consensus review by two expert radiologists resulted in the detection of 104 subsolid nodules larger than 3 mm (74 nodules of ground glass attenuation and 30 mixed nodules with solid and ground glass components). The results from this review were used as a gold standard to determine the performances of the CAD system and 3 independent clinical radiologists involved with the primary interpretations. RESULTS: The sensitivity of the CAD system for the detection of ground glass opacities and mixed nodules was 53% and 73% respectively. These values were not statistically different from the values for the 3 independent observers (42-66% for ground glass opacities and 63-80% for mixed nodules). The sensitivity of each observer significantly increased when the nodules detected by the CAD system were added to those detected by each observer (p<0.0001). CONCLUSION: A CAD system has a potential impact on the detection rate of subsolid nodules by radiologists.
