Early time-related course of image findings in postmortem MRI: Typical findings and observer agreement in a porcine model

TY - JOUR

T1 - Early time-related course of image findings in postmortem MRI: Typical findings and observer agreement in a porcine model

AU - Henes, Frank Oliver

AU - Regier, Marc

AU - Bannas, Peter

AU - Henker, Marlen

AU - Heinemann, Axel

AU - Sperhake, Jan

AU - Begemann, Philipp G C

AU - Adam, Gerhard

AU - Groth, Michael

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2017/9

Y1 - 2017/9

N2 - PURPOSE: To assess early time-related image findings in postmortem magnetic resonance imaging (MRI) and to evaluate observer agreement in a porcine model.MATERIAL AND METHODS: Three pigs were examined by MRI at 15 different time points in the first 36h after death. Two observers independently recorded the postmortem interval (PMI) to the appearance of fluid collection (pleural space, interlobar and interlobular pulmonary fissures and hepatic interlobar fissures), gas accumulation (intrahepatic and intracardial) and blood clotting (aorta and intrahepatic venous vessels). Cohen's Kappa statistics and intraclass correlation coefficient (ICC) were used to evaluate intra- and interobserver agreement.RESULTS: Intrahepatic gas was evident after 12, 17 and 30h. Also, intracardiac gas was present in all animals. However, no chronological appearance has been observed. Blood clotting in the hepatic vein was observed within 3min, aortic clotting with a delay of 2-12h after death. Interlobular pulmonary fluid (median PMI: 2h, range 2-2h), pleural effusion (median PMI: 10.5h, range 9-12h) and hepatic interlobar fissure fluid (median PMI: 11.5h, range 11-12h) displayed a chronological appearance pattern. Qualitative and quantitative detection of most postmortem findings showed excellent intra- and interobserver agreement with Kappa values>0.8 or ICC>0.75.CONCLUSION: Pulmonary and hepatic fissural fluid collection as well as intravasal gas accumulation are early time-related image findings in postmortem MRI. The chronological appearance of these findings can be assessed with excellent observer agreement in a porcine model.

AB - PURPOSE: To assess early time-related image findings in postmortem magnetic resonance imaging (MRI) and to evaluate observer agreement in a porcine model.MATERIAL AND METHODS: Three pigs were examined by MRI at 15 different time points in the first 36h after death. Two observers independently recorded the postmortem interval (PMI) to the appearance of fluid collection (pleural space, interlobar and interlobular pulmonary fissures and hepatic interlobar fissures), gas accumulation (intrahepatic and intracardial) and blood clotting (aorta and intrahepatic venous vessels). Cohen's Kappa statistics and intraclass correlation coefficient (ICC) were used to evaluate intra- and interobserver agreement.RESULTS: Intrahepatic gas was evident after 12, 17 and 30h. Also, intracardiac gas was present in all animals. However, no chronological appearance has been observed. Blood clotting in the hepatic vein was observed within 3min, aortic clotting with a delay of 2-12h after death. Interlobular pulmonary fluid (median PMI: 2h, range 2-2h), pleural effusion (median PMI: 10.5h, range 9-12h) and hepatic interlobar fissure fluid (median PMI: 11.5h, range 11-12h) displayed a chronological appearance pattern. Qualitative and quantitative detection of most postmortem findings showed excellent intra- and interobserver agreement with Kappa values>0.8 or ICC>0.75.CONCLUSION: Pulmonary and hepatic fissural fluid collection as well as intravasal gas accumulation are early time-related image findings in postmortem MRI. The chronological appearance of these findings can be assessed with excellent observer agreement in a porcine model.

KW - Journal Article

U2 - 10.1016/j.legalmed.2017.07.005

DO - 10.1016/j.legalmed.2017.07.005

M3 - SCORING: Journal article

C2 - 28738216

VL - 28

SP - 15

EP - 21

JO - LEGAL MED-TOKYO

JF - LEGAL MED-TOKYO

SN - 1344-6223

ER -