EDITORIAL European Heart Journal - Cardiovascular Imaging (2018) 19, 729 doi:10.1093/ehjci/jey026 Invited commentary on diagnostic accuracy of postmortem computed tomography, magnetic resonance imaging, and computed tomography-guided biopsies for the detection of ischaemic heart disease in a hospital setting Christian Jackowski* Institute of Forensic Medicine, University of Bern, Bu¨hlstr. 20, CH-3012 Bern, Switzerland Online publish-ahead-of-print 20 February 2018 This editorial refers to ‘Diagnostic accuracy of postmortem postmortem imaging from the forensic use into the clinical setting and provides valuable results to justify its application as alternative computed tomography, magnetic resonance imaging, and postmortem examination technique for the clinical patient. I would computed tomography-guided biopsies for the detection like to congratulate the authors on this milestone. In the clinical envi- of ischaemic heart disease in a hospital setting’ by I.M. ronment postmortem imaging will help to counteract the loss of valid Wagensveld et al., pp. 739–748. postmortem information due to the declining clinical pathology 1 . autopsy rates. Clinician’s will get the consent of the next of kin easier The authors around Dr Wagensveld et al. investigated postmortem . for this non-invasive or minimal-invasive imaging examination com- computed tomography (CT), magnetic resonance imaging, and CT- . pared to the hesitations they experience when asking for consent for guided biopsies as alternative postmortem examination techniques . an autopsy. This will have a positive effect on the amount of postmor- for deceased patients who suffered from ischaemic heart disease. tem diagnostics in general as well as on the quality of the national Since almost 20 years postmortem imaging has been increasingly . mortality statistics. This development has to be further promoted! implemented in the forensic environment to examine corpses. Especially, over the past decade postmortem MR proved to be feasi- Conflict of interest: None declared. ble to non-invasively diagnose ischaemic myocardial alterations. Even age staging of the myocardial lesions is possible by comparing the sig- References nal intensities in T2-weighted short axis images. Especially in very . 1. Wagensveld IM, Blokker BM, Pezzato A, Wielopolski PA, Renken NS, von der Thu¨sen JH et al. Diagnostic accuracy of postmortem CT, MRI and CT-guided early stages (peracute infarction) postmortem MR seems to be more biopsies for the detection of ischaemic heart disease in a hospital setting. Eur sensitive to ischaemic lesions than the human eye is at autopsy possi- . Heart J Cardiovasc Imaging 2018;19:739–48. bly due to tiny changes of the tissue pH-value and local oedematous 2. Jackowski C, Christe A, Sonnenschein M, Aghayev E, Thali MJ. Postmortem unen- 2–5 hanced magnetic resonance imaging of myocardial infarction in correlation to his- reactions. tological infarction age characterization. Eur Heart J 2006;27:2459–67. In the forensic setting, postmortem MR is intended to improve the . 3. Jackowski C, Hofmann K, Schwendener N, Schweitzer W, Keller-Sutter M. Coronary thrombus and peracute myocardial infarction visualized by unenhanced sensitivity for the detection of ischaemic lesions, and it is used as an postmortem MRI prior to autopsy. Forensic Sci Int 2012;214:e16–9. additional and not as an alternative technique. However, the experi- . 4. Jackowski C, Schwendener N, Grabherr S, Persson A. Post-mortem cardiac 3-T ence made in the forensic setting allowed meanwhile to broaden the . magnetic resonance imaging: visualization of sudden cardiac death? J Am Coll Cardiol 2013;62:617–29. application of postmortem cross-sectional imaging into the area of . 5. Jackowski C, Warntjes MJ, Berge J, Bar W, Persson A. Magnetic resonance imaging clinical pathology, which suffers from declining autopsy rates since . . goes postmortem: noninvasive detection and assessment of myocardial infarction decades. The present publication is an important step in pushing by postmortem MRI. Eur Radiol 2011;21:70–8. The opinions expressed in this article are not necessarily those of the Editors of EHJCI, the European Heart Rhythm Association or the European Society of Cardiology. * Corresponding author. Tel: 0041 (0) 31 631 84 12. E-mail: email@example.com Published on behalf of the European Society of Cardiology. All rights reserved. V The Author(s) 2018. For permissions, please email: firstname.lastname@example.org. Downloaded from https://academic.oup.com/ehjcimaging/article-abstract/19/7/729/4883340 by Ed 'DeepDyve' Gillespie user on 26 June 2018
European Heart Journal – Cardiovascular Imaging – Oxford University Press
Published: Feb 20, 2018
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