Changes in magnetic resonance imaging relaxation time on postmortem magnetic resonance imaging of formalin-fixed human normal heart tissue

Abstract

Background Postmortem magnetic resonance imaging (MRI) has been used to investigate the cause of death, but due to time constraints, it is not widely applied to the heart. Therefore, MRI analysis of the heart after formalin fixation was previously performed. However, the changes in MRI signal values based on the fixation time of formalin were not investigated. The objective was to investigate changes over time in the T1- and T2-values of MRI signals in normal areas of hearts removed during autopsy, hearts subsequently fixed in formalin, and heart specimens sliced for the preparation of pathological specimens. Methods The study subjects were 21 autopsy cases in our hospital between May 26, 2019 and February 16, 2020 whose hearts were removed and scanned by MRI. The male:female ratio was 14:7, and their ages at death ranged from 9 to 92 years (mean age 65.0 ± 19.7 years). Postmortem (PM)-MRI was conducted with a 0.3-Tesla (0.3-T) scanner containing a permanent magnet. A 4-channel QD head coil was used as the receiver coil. Scans were performed immediately after removal, post-formalin fixation, and after slicing; 7 cases were scanned at all three time points. Results The T1- and T2-values were calculated from the MRI signals of each sample organ at each scanning stage. Specimens were sliced from removed organs after formalin fixation, and the changes in T1- and T2-values over time were graphed to obtain an approximate curve. The median T1-values at each measurement time point tended to decrease from immediately after removal. The T2-values showed the same tendency to decrease, but this tendency was more pronounced for the T1-values. Conclusion MRI signal changes in images of heart specimens were investigated. Formalin fixation shortened both T1- and T2-values over time, and approximation formulae were derived to show these decreases over time. The shortening of T1- and T2-values can be understood as commensurate with the reduction in the water content (water molecules) of the formalin-fixed heart.

Sudden Cardiac Death and Ex-Situ Post-Mortem Cardiac Magnetic Resonance Imaging: A Morphological Study Based on Diagnostic Correlation Methodology

“…On the other hand, not all the information coming from PMCMR have found, to date, a histopathological equivalent or interpretation, such as diffusion-weighted imaging (DWI) or spectroscopy for the chemical study of tissues [ 28 ]. Furthermore, a recent study suggests that formol fixation could induce changes in the MRI signal [ 29 ]. Although, therefore, further studies are certainly necessary, compared to PMCT, PMMRI seems to be a very promising method in the study of the myocardium in cases of sudden cardiac death [ 30 , 31 , 32 ].…”

Transverse relaxation in fixed tissue: Influence of temperature and resolution on image contrast in magnetic resonance microscopy

“…Although the mainstream MRI/MRM revolves around tissue in vivo, imaging of FF tissue is still important as it bridges in vivo imaging with histology 81 . Also, there is a high interest in imaging postmortem tissue, which most frequently is fixed 3,5,6,8,82 . Therefore, a suitable model for FF tissue relaxation is welcome.…”

“…81 Also, there is a high interest in imaging postmortem tissue, which most frequently is fixed. 3,5,6,8,82 Therefore, a suitable model for FF tissue relaxation is welcome. Because FF tissue is scanned at different temperatures and different resolutions, it is desirable to have a model that could translate measured relaxation times at arbitrary temperature and resolution to some common conditions (e.g., room temperature and 100 μm/pxl).…”

“…Figure 1 shows the relaxation rate and relaxation time dependence according to the TRADE model expressed by Equations (1)(2)(3)(4)(5)(6)(7)(8). We use the relaxation rate and relaxation time interchangeably because rates have physical meanings (relaxation rates are additive), but the relaxation times were measured experimentally.…”

“…Magnetic resonance imaging (MRI) and magnetic resonance microscopy (MRM) of fixed tissue have become increasingly useful for pathological analysis of postmortem tissue, 1–8 sparking research in fixed tissue nuclear magnetic resonance (NMR) characterization. It is desirable to have a suitable model for the fixed tissue relaxation that could reconcile conflicting reports on the fixation effects on the image contrast 4,7 .…”