MR Autopsy in Fetuses

Abstract

Objective: The purpose of this study was to determine whether postmortem magnetic resonance imaging (MR autopsy) could serve as an alternative to necropsy of fetuses. The value of MR autopsy in the validation of the obstetric management and in risk counseling concerning future pregnancies is discussed. Methods: 10 consecutive, malformed fetuses were examined by postmortem MRI within 24 h of delivery. Prenatal ultrasound (US) was performed in all fetuses. Complete necropsy served as gold standard. Results: MR autopsy confirmed every US diagnosis responsible for termination. All MRI findings were confirmed by necropsy. In two fetuses, necropsy gave additional information relevant for risk counseling. Histologic examination corrected the diagnosis in one case. Conclusions: MR autopsy provides valuable information previously only available from necropsy. In parents who refuse perinatal necropsy, the information obtained by MR autopsy can be used to validate obstetric management and to evaluate the risk for future pregnancies. Necropsy however remains the gold standard.

Combined Prenatal Ultrasound and Magnetic Resonance Imaging in an Extensive Congenital Fibrosarcoma: A Case Report and Review of the Literature

“…For differential diagnosis, hepatoblastoma and neuroblastoma were not considered because the fetal liver and bilateral kidneys had clear demarcation on MRI. Teratomas or other soft tissue tumors would be difficult to differentiate from a sarcoma by ultrasound and MRI evaluation [9].…”

Truncus arteriosus communis in a midtrimester fetus: comparison of prenatal ultrasound and MRI with postmortem MRI and autopsy

“…Prenatal MRI of the fetus will not replace ultrasound as a screening modality, but provides additional diagnostic information, as demonstrated by our case, making it a useful tool in assessing malformations of the heart. Either fetal MRI or postmortem MRI is important in ruling out additional malformations [28,29].…”

Minimally invasive fetal postmortem examination using magnetic resonance imaging and computerised tomography: current evidence and practical issues

“…Nevertheless, several research groups have subsequently performed PM MRI scanning in groups of selected cases and have reported its use in small studies (Woodward et al, 1997;Huisman et al, 2002;Alderliesten et al, 2003;Griffiths et al, 2003;Breeze et al, 2006;Brookes and Hagmann, 2006;Widjaja et al, 2006;Cohen and Whitby, 2007;Hagmann et al, 2007;Cohen et al, 2008; Table 1). With recent renewed interest in the possibility of the development of less invasive postmortem examination, for the reasons described earlier, the need for evidence regarding the accuracy of PM MRI has regained its importance.…”