Figure 4
Post-mortem histopathology with correlating MR image and correlating CT image in two patients with death secondary to primary vascular cause. (A, B and C) Patient 5 with aortic dissection and cardiac tamponade. Aorta showing marked cystic medial degeneration with large pools of acid mucin. Marked disruption of the elastin fibres is noted. Movat pentachrome stain, 10x objective. MR 3-d whole heart image demonstrating severe ascending aortic dilatation, where there is aortic dissection noted posteriorly and there is an associated large haemopericardium. CT image also demonstrating dilated ascending aorta and haemopericardium. The region of dissection is less well identified due to the lower resolution of this scan when compared to the dedicated MR imaging. (D, E and F) Patient 12 with bilateral pulmonary emboli. Occlusive thromboembolism showing early healing by organisation in large pulmonary artery. Movat pentachrome stain, 2x objective. MR 3-d whole heart image demonstrating bilateral pulmonary emboli in the distal branch pulmonary arteries. Note the heterogeneous signal from this region of clot, especially when compared to the more proximal pulmonary arteries, which is more typical of the expected homogenous signal derived from post-mortem related clot. CT showing the branch pulmonary arteries, where clot in the distal RPA is better visualised than in the LPA and the imaging is generally lower resolution than the dedicated MR Imaging.