MRI in fetal necropsy

Abstract

The fetal autopsy involves a series of investigations of the corpse, most of which are noninvasive and acceptable to the majority of parents and their physicians. The value of the perinatal autopsy is manyfold and well established, and the results can provide a basis for parental and family counseling, inform future obstetric management, and provide audit for prenatal care. Many techniques originally developed for diagnosis, such as histology, biochemical tests, photography, x-rays, and cytogenetic karyotyping, have become standard tools in perinatal autopsies. However, there has been an inexorable decline in the autopsy consent rate over the last 30 years due to social and cultural factors, and perhaps ignorance of the benefits to be derived from the examination. Growing evidence suggests that postmortem fetal MRI can assist the pathologist at autopsy, and in many cases can obviate the need for dissection or at least minimize and focus it. For the majority of cases in which no consent for surgical autopsy is given, MRI together with other noninvasive postmortem tests can provide a great deal of the information that was previously available only from autopsy.

Comparison of postmortem ultrasound and X-Ray with autopsy in fetal death: Retrospective study of 169 cases

“…Compared to MRI [11][12][13], ultrasound has a number of advantages and limitations, summarized in Table 5. Contrary to MRI, younger is the fetus better is the US examination because of the smaller size of the corpse [ Fig.…”

‘You're looking for different parts in a jigsaw’: foetal MRI (magnetic resonance imaging) as an emerging technology in professional practice

“…Antenatal MRI was used to inform foetal or neonatal post‐mortem. It was particularly useful in identifying problems with the brain and could directly inform dissection or provide information for parents who did not want to consent to traditional autopsy (Brookes and Hagmann ). As articulated by one of the pathologists below :

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The use of magnetic resonance in the hospital and coronial pediatric postmortem examination

“…Moreover, a novel transdisciplinary research project combines the use of Forensic Medicine, Pathology, Radiology, Image Processing, Physics and Biomechanics with the aim to improve current forensic examination techniques or even develop suitable alternatives [25,26]. The diagnosis was easily identified at the gross examination (b) and confirmed with histology (e, H&E 40x) As in previous investigations conducted in fetal and perinatal PMs [17,[27][28][29], the latest study of coronial autopsies demonstrates a high percentage of agreement between the traditional autopsy and the PM MR/findings. One gross disadvantage of the PM MRI was the "reading" of two cases of acute meningitis as a subdural hemorrhage.…”