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Inversion time optimization in postmortem 1.5 tesla FLAIR brain imaging: a pilot study
Christine Bruguier1,2, V Magnin3, J-F Knebel4
1Department of Medical Radiology, Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne, 1011, Switzerland. christine.bruguier@chuv.ch.
Introduction:
Postmortem magnetic resonance imaging (PMMR) has gained importance during the last decade in forensic pathology. While many clinical radiology sequences are applicable for the evaluation of the brain, the 3D FLAIR sequence shows different contrast in postmortem cases compared to living patients. Two factors-the temperature and the interval between official declaration of the death and PMMR (DC-PMMR interval) are suspected to influence the optimal inversion time (TI) needed to achieve living patient-like image contrast. This study aimed to investigate if our empirical approach had the same results as previous study.
Materials And Methods:
3D FLAIR sequences with varying TI values (from 1660 ms to 900 ms, every 110 ms) were acquired. Two radiologists independently assessed the images, selecting the TI that produced the most patient-like contrast. Rectal temperature and the DC-PMMR interval were recorded, and Pearson correlation tests were conducted to evaluate interrelations between TI, temperature, and DC-PMMR interval. Interobserver reliability was assessed using PABAK.
Result:
Overall, 23 cases were analyzed. Rectal temperature ranged from 5.7 °C to 29.0 °C, and the DC-PMMR interval from 13.05 to 768 h. A moderate interobserver reliability (PABAK = 0.56) was observed. Significant correlations were observed between TI and both temperature (r = 0.70, p = 0.0014) and DC-PMMR interval (r = - 0.68, p < 0.0003).
Conclusion:
Our empirical approach trends the results of previous studies: Postmortem 3D FLAIR contrast is significantly affected by the temperature and the DC-PMMR interval, suggesting that TI should be adapted accordingly.
Insights
Postmortem MRI 3D FLAIR contrast is influenced by body temperature and time since death. Adjusting inversion time (TI) based on these factors is crucial for accurate postmortem imaging.
Area of Science:
- Forensic Pathology
- Radiology
- Medical Imaging
Background:
- Postmortem magnetic resonance imaging (PMMR) is increasingly vital in forensic pathology.
- Clinical 3D FLAIR sequences require adaptation for postmortem brain evaluation due to altered contrast.
- Temperature and postmortem interval (DC-PMMR) are suspected to affect optimal inversion time (TI).
Purpose of the Study:
- To investigate the influence of temperature and DC-PMMR interval on optimal TI for postmortem 3D FLAIR imaging.
- To validate an empirical approach for achieving living-patient-like contrast in PMMR.
- To determine if previous study findings are replicated.
Main Methods:
- Acquisition of 3D FLAIR sequences with varied TI values (1660 ms to 900 ms).
- Independent assessment by two radiologists to select the optimal TI for lifelike contrast.
- Recording of rectal temperature and DC-PMMR interval, with Pearson correlation analysis.
- Interobserver reliability assessed using PABAK.
Main Results:
- Analysis of 23 cases with temperatures from 5.7°C to 29.0°C and DC-PMMR intervals from 13.05 to 768 hours.
- Moderate interobserver reliability (PABAK = 0.56).
- Significant correlations found between TI and temperature (r=0.70, p=0.0014) and TI and DC-PMMR interval (r=-0.68, p<0.0003).
Conclusions:
- Postmortem 3D FLAIR contrast is significantly influenced by temperature and the DC-PMMR interval.
- The optimal TI for PMMR 3D FLAIR imaging should be adapted based on these parameters.
- Empirical findings align with previous research, supporting the need for adjusted TI in postmortem imaging.
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