Post-mortem magnetic resonance foetal imaging: a study of morphological correlation with conventional autopsy and histopathological findings

Abstract

The aim of the present study is to offer our experience concerning post-mortem magnetic resonance (PMMR) in foetal death cases and an evaluation of the differences between the findings acquired by PMMR and by forensic autopsy. Fifteen foetuses were recruited from July 2014 to December 2015. These had suffered intrauterine death in women in the 21st to 38th week of gestation who were treated in the emergency department for non-perception of foetal movements. We performed a PMMR on foetuses, 3 ± 1 days on average from the time of death, and then a complete forensic autopsy was performed. All 15 foetuses were examined with a whole-body study protocol, starting from the skull, down to and including the lower limbs. The total time of examination ranged from 20 to 30 min in each case. The external evaluation and description of post-mortem phenomena (maceration), record of the weight and detection and the various measurements of foetal diameters were evaluated before performing autopsy. A complete histopathological study was performed in each case. Out of 15 cases examined, eight were negative for structural anatomical abnormalities and/or diseases, both in the preliminary radiological examination and the traditional autopsy. In the remaining seven cases, pathological findings were detected by PMMR with corresponding results at autopsy. PMMR can provide useful information on foetal medical conditions and result in improved diagnostic classification. It may enable the planning of a more suitable technique before proceeding to autopsy, including focusing on certain aspects of organ pathology otherwise not detectable. The association between PMMR, post-mortem examination and related histological study of the foetus-placenta unit could help reduce the percentage of cases in which the cause of foetal death remains unexplained. Lastly, it may allow a selective sampling of the organ in order to target histological investigations.

Postmortem magnetic resonance imaging vs autopsy of second trimester fetuses terminated due to anomalies

“…This was not due to a longer interval between the termination and the MRI examination. Thus, the CNS anomalies were correctly assessed by the radiologists to a high degree, which confirms the results from previous studies . These studies, however, mostly included fetuses of higher gestational ages and infants.…”

Multidisciplinary approach to suspected sudden unexpected infant death caused by milk-aspiration: A case report

“…Recently, the association between post-mortem magnetic resonance, post-mortem examination and related histological study of the foetus or newborn could help reduce the percentage of cases in which the cause of death remains unexplained. Lastly, it may allow a selective sampling of the organ in order to target histological investigations[ 14 ].…”

Comparison of postmortem whole‐body contrast‐enhanced microfocus computed tomography and high‐field magnetic resonance imaging of human fetuses

“…However, parental acceptance of fetal autopsy has decreased over time, mainly due to the invasiveness of the procedure 3,4 . In recent years, non-invasive alternatives have been suggested, including postmortem magnetic resonance imaging (MRI) [5][6][7] , radiography and computed tomography (CT) 8,9 . These alternatives are preferred increasingly by parents, since they do not harm the integrity of the body 4 .…”