FEATURES OF MRI CHARACTERISTICS OF POSTMORTEM CHANGES IN THE LIVER AND LUNGS OF DECEASED NEWBORNS DEPENDING ON THE TIME OF DEATH
Tumanova U.N.¹, Savva¹ O.V.1,², Bychenko V.G.¹, Shchegolev A.I.1
1 - V.I .Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology. Moscow, Russia.
2 - State Budgetary Institution of the Ryazan region "D.I. Mastbaum Bureau of Forensic Medicine. Ryazan, Russia.
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urpose. To conduct a comparative analysis of the MRI characteristics of postmortem changes in the liver and lungs, depending on the time of death.
Material and methods. The work is based on a comprehensive analysis of postmortem MRI data and the results of pathological autopsies of 103 newborns. All the bodies of newborns after death were stored in a refrigerator at a temperature of + 4 ° C in the supine position of the body. Postmortem MRI examination of the bodies of deceased newborns was carried out before the pathological autopsy using a 3T Siemens Magnetom Verio device, followed by analysis of T1- and T2-weighted images (WI). The intensity of the MR signal in the tissue upper and lower regions of the liver and lungs in relation to the position of the body after death was visually assessed on tomograms. The values of the MR signal intensities in the upper and lower regions of the liver and lungs in relation to the position of the body after death, as well as the intensity of the MR signal in the pleural fluid on the axial projection of tomograms were determined quantitatively. Based on the data obtained, the difference and ratio of MR signal intensities (SIS) in the upper and lower regions of the organ on T2-WI and T1-WI, as well as MRI values of the index of the postmortem state of the liver and lungs were calculated.
Results. Visual analysis of MR tomograms in most cases revealed varying degrees of intensity of the MR signal in the upper and lower regions of the liver and, accordingly, the presence of a gradient of the MR signal. The presence of a gradient and, accordingly, the boundary of the intensity of the MR signal in the upper and lower regions somewhat less frequently than in the liver was noted in the visual analysis of MR tomograms of the lungs. At the same time, the severity of this gradient and, accordingly, its boundaries differed on T1-WI and T2-WI, as well as in groups with different duration of death. The calculated ratios of the average values of signal intensities in the upstream part of the liver to similar values in the downstream part of the liver were less than 1 in most groups, with lower levels on T1-weighted images. The average values of the MRI index of the postmortem state of the liver in all groups had greater values in the lower area of the liver compared with the upper area. At the same time, the values obtained decreased in the first 18 hours after death, and then had a wave-like character. Similar values of the MRT index of the postmortem state of the lungs were wave-like character with a tendency to decrease as the duration of death increased.
Conclusion. The data obtained convincingly indicate that postmortem MRI is a highly effective and non-invasive method of studying the bodies of deceased newborns, allowing visualizing the development of non-specific postmortem changes in internal organs. Based on a quantitative assessment of the intensity of the MR signal in the upper and lower regions of the organ relative to the position of the body after death, the features of the formation of postmortem changes in liver and lung tissue have been established. This facilitates the subsequent analysis of morphological changes detected at the autopsy and the determination of the links of thanatogenesis. The knowledge gained about postmortem changes during radiology studies will improve the quality of their assessment and differential diagnosis of intravital lesions and cadaveric changes.
Keywords: newborn, postmortem changes, postmortem hypostasis, postmortem MRI, time of death.
Corresponding author: Tumanova U.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Tumanova U.N., Savva O.V., Bychenko V.G., Shchegolev A.I. Features of MRI characteristics of postmortem changes in the liver and lungs of deceased newborns depending on the time of death. REJR 2024; 14(2):95-112. DOI: 10.21569/2222-7415-2024-14-2-95-112.
Received: 22.02.24 Accepted: 10.04.24