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2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Introduction

Although the “conventional” autopsy is still considered the “gold standard” for the definition of the cause of death, an emerging interest in non-invasive cadaveric investigations is spreading. Among all these, the application of post-mortem magnetic resonance imaging of the heart is increasingly gaining ground in the study of sudden cardiac death.

Methods

Using the diffusion tensor imaging sequence, the present study aimed to demonstrate how through the fractional anisotropy value it is possible to qualitatively and quantitatively define sudden cardiac death, particularly in cases of sudden arrhythmic death syndrome. Four hearts were collected for the present pilot study: the first from a subject who died from a brain injury caused by a gunshot, and the other three hearts from subjects who died of sudden cardiac death. In all cases examined, the extracted hearts were hung inside a container containing 10% formalin solution and placed inside a 1.5T scanner with a 16-channel chest coil. Then, the cardiac diffusion tensor imaging sequence was performed and the quantitative maps of fractional anisotropy and apparent diffusion coefficient were obtained. After imaging analysis, the samples were processed, paraffin-embedded, and stained with hematoxylin and eosin and trichrome staining. Cases B, C, and D showed lower fractional anisotropy values than non-pathological one.

Results

Histological investigation revealed extensive areas of fibrosis and foci of contraction band necrosis in heart B, myofiber disarray and interstitial fibrosis in heart C, and findings consistent with atonic death in heart D.

Conclusion

The study aimed to demonstrate that in cases of sudden cardiac death, lower fractional anisotropy values, as already observed in clinical trials, are associated with arrhythmic heart disease or myocardial infarction. Quantitative, appreciable, and reproducible data could support such diagnoses.

© 2025 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Post-mortem Cardiac MRI in Sudden Cardiac Death: The Interesting Intertwining of Radiology and Histology to Diagnose Arrhythmic Death or Myocardial Infarction
Curr. Med. Imaging 21, E15734056343601 (2025); https://doi.org/10.2174/0115734056343601250123093759
/content/journals/cmim/10.2174/0115734056343601250123093759
/content/journals/cmim/10.2174/0115734056343601250123093759
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  • Article Type:     Research Article
Keyword(s): Arrhythmic death; Cardiac diffusion tensor imaging; Fractional anisotropy; Myocardial infarction; Post-mortem magnetic resonance; Sudden cardiac death

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