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
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