Acceptance, reliability and confidence of diagnosis of fetal and neonatal virtuopsy compared with conventional autopsy: a prospective study

Abstract

Objectives To compare prospectively maternal acceptance of fetal and neonatal virtuopsy with that of conventional autopsy and to determine the confidence with which magnetic resonance (MR) virtuopsy can be used to diagnose normality/abnormality of various fetal anatomical structures. Methods

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

“…PM imaging was considered acceptable by 99% of the parents involved, including the 33% of parents who did not consent to conventional autopsy, and religious groups for whom conventional autopsy was not acceptable. 18 We examined parental attitudes towards MIA in a qualitative study funded by the Lullaby Trust, London, UK. Most parents reported that the fact that the head would not be cut open was an important factor in choosing MIA over conventional autopsy or no autopsy.…”

“…This study found that, in 60% of cases, MRI had equivalent or better diagnostic sensitivity than conventional autopsy, but included only 20 patients. Since then, many other similar small-scale studies [16][17][18][19][20][21] have shown the potential of PMMR, particularly for the central nervous system (CNS) ( Table 1). Brain and spinal cord anomalies account for 20% of fatal congenital abnormalities in foetuses, and PMMR has a high sensitivity and specificity for detecting these abnormalities in foetuses.…”

Perinatal and paediatric post-mortem magnetic resonance imaging (PMMR): sequences and technique

“…A comprehensive literature search revealed over 15 different protocols described at 1.5 T or 3.0 T since perinatal PMMR began almost 20 years ago. A summary of the main published protocols is given in Table 1, [8][9][10][11][12][13][14][15][16][17][18][19][20] together with a summary of our group's current protocol which is described in this article in more detail. We excluded studies which described only the adult population, higher field strengths (7.0 or 9.4 T) MR, and reference the first article where more than one article from the same group has used the same protocol.…”

“…Some groups also describe using T 1 weighted (T1-w) sequences 11,13,19 or 3D T1-w sequences, 10,17,18 but most authors report that T1-w brain imaging added little, generally due to a lack of tissue contrast. 9,14 Only within the past 5 years have some authors begun to use susceptibilityweighted sequences to detect subtle haemorrhage.…”

Fetal organ weight estimation by postmortem high‐field magnetic resonance imaging before 20 weeks' gestation

“…This low rate reflects the difficulties that fetal medicine specialists face in obtaining parental consent for a conventional autopsy 2 . In circumstances where consent is declined for conventional autopsy, postmortem magnetic resonance imaging (MRI) allows minimally invasive autopsy, with much higher acceptance rates 3,4 . Measurement of the weights of visceral organs represents an important component of autopsy.…”