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[Roentgenologic heart volume determination for the diagnosis of fatal heart failure]
G Schmidt1, D Kallieris, P Stosch
1Institut für Rechtsmedizin im Klinikum, Universität Heidelberg, Bundesrepublik Deutschland.
Insights
This study establishes a formula correlating cardiac shadow plane on X-rays to actual cardiac volume, aiding in non-invasive cardiac assessment. The findings show a strong link between radiograph measurements and autopsy-determined cardiac volumes.
Area of Science:
- Forensic Pathology
- Radiology
- Cardiovascular Science
Background:
- Determining cardiac volume non-invasively is crucial for medical diagnosis and forensic analysis.
- Previous methods for estimating cardiac volume from radiographic images have limitations.
Purpose of the Study:
- To establish a reliable formula correlating the cardiac shadow plane on anterior-posterior thoracic radiographs with actual cardiac volume.
- To validate this formula using autopsy data and compare estimated volumes in various death scenarios.
Main Methods:
- Analysis of 385 anterior-posterior thoracic radiographs and corresponding autopsy-determined cardiac volumes.
- Development and application of the formula: Hvol = 0.49 x Fa x sqrt(Fa).
- Validation using water displacement method on 25 cadavers and comparison of cardiac volumes in different causes of death.
Main Results:
- A strong correlation (r = 0.984) was found between cardiac shadow plane and cardiac volume.
- The derived formula accurately estimates cardiac volume from radiographic measurements.
- Cardiac blood volumes in cases of poisoning, drowning, suffocation, and hanging were comparable to those in natural cardiac death.
Conclusions:
- The cardiac shadow plane on thoracic radiographs is a reliable indicator of cardiac volume.
- The developed formula provides a valuable tool for non-invasive estimation of cardiac volume in clinical and forensic settings.
- Cardiac volume estimations can be useful in differentiating causes of death, particularly in cases involving asphyxia or poisoning.
Abstract:
In order to investigate the connection between the cardiac volume and the cardiac shadow plane, 385 anterior-posterior radiographs of the thorax have been selected comparing their cardiac shadow plane with the corresponding cardiac volumes determined by the autopsy of the cadavers. The comparison showed a connection of both magnitudes by means of the formula Hvol = 0.49 x Fa x square root of Fa (Hvol = cardiac volume in cm3, Fa = cardiac shadow plane of the anterior-posterior radiograph in cm2, corrections were made from the radiation divergence). A verification of the formula showed a very high correlation (r = 0.984) in 25 cadavers to be dissected. The comparing volume of the cardiac shadow plane has been investigated by means of the water displacement method, in which the cardiac vessels were ligated and the heart taken out of the cadaver. The cardiac volume, evaluated from the cardiac shadow plane showed a significant correlation at the cardiac death by internal natural cause. The comparison of the mathematical evaluated cardiac blood volumes of the symptoms causing death showed that the cardiac blood volumes in the group of poisonings and the group of drowning, suffocations and hanging with 231 ml and 211 ml in the men collective were at the same level as the cardiac death (246 ml). About the same applied to the women collective.(ABSTRACT TRUNCATED AT 250 WORDS)