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
| Autor: | Britt M. Blokker, J. Wolter Oosterhuis, Nomdo S. Renken, Andrea Pezzato, Annick C. Weustink, M. G. Myriam Hunink, Ivo M. Wagensveld, Piotr A. Wielopolski, Jan H. von der Thüsen, Gabriel P. Krestin |
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| Přispěvatelé: | Pathology, Radiology & Nuclear Medicine, Epidemiology |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Image-Guided Biopsy Male medicine.medical_specialty Myocardial Infarction Myocardial Ischemia Autopsy Computed tomography Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Biopsy medicine Humans Radiology Nuclear Medicine and imaging Hospital Mortality Prospective Studies 030216 legal & forensic medicine Prospective cohort study Aged Aged 80 and over Observer Variation Academic Medical Centers medicine.diagnostic_test Receiver operating characteristic business.industry Magnetic resonance imaging General Medicine Middle Aged Magnetic Resonance Imaging Confidence interval Cross-Sectional Studies ROC Curve Area Under Curve Acute Disease Chronic Disease Female Radiology Tomography Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal-Cardiovascular Imaging, 19(7), 739-748. Oxford University Press |
| ISSN: | 2047-2404 |
| Popis: | Aims The autopsy rate worldwide is alarmingly low (0-15%). Mortality statistics are important, and it is, therefore, essential to perform autopsies in a sufficient proportion of deaths. The imaging autopsy, non-invasive, or minimally invasive autopsy (MIA) can be used as an alternative to the conventional autopsy in an attempt to improve postmortem diagnostics by increasing the number of postmortem procedures. The aim of this study was to determine the diagnostic accuracy of postmortem magnetic resonance imaging (MRI), computed tomography (CT), and CT-guided biopsy for the detection of acute and chronic myocardial ischaemia. Methods and results We included 100 consecutive adult patients who died in hospital, and for whom next-of-kin gave permission to perform both conventional autopsy and MIA. The MIA consists of unenhanced total-body MRI and CT followed by CT-guided biopsies. Conventional autopsy was used as reference standard. We calculated sensitivity and specificity and receiver operating characteristics curves for CT and MRI as the stand-alone test or combined with biopsy for detection of acute and chronic myocardial infarction (MI). Sensitivity and specificity of MRI with biopsies for acute MI was 0.97 and 0.95, respectively and 0.90 and 0.75, respectively for chronic MI. MRI without biopsies showed a high specificity (acute: 0.92; chronic: 1.00), but low sensitivity (acute: 0.50; chronic: 0.35). CT (total Agatston calcium score) had a good diagnostic value for chronic MI [area under curve (AUC) 0.74, 95% confidence interval (CI) 0.64-0.84], but not for acute MI (AUC 0.60, 95% CI 0.48-0.72). Conclusion We found that the combination of MRI with biopsies had high sensitivity and specificity for the detection of acute and chronic myocardial ischaemia. |
| Databáze: | OpenAIRE |
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