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

Addison, S; Arthurs, Owen J.; Thayyil, Sudhin

doi:10.1259/bjr.20130621

Cited by 59 publications

(46 citation statements)

References 46 publications

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“…This is one of a recently increasing number of cases where radiological data provided sufficient information regarding the cause and manner of death and thus might serve as triage to distinguish a natural from an unnatural death. [20][21][22][23][24] Therefore, PMCTA will certainly become requisite in the future and will play an important role in understanding and defining the cause of death.…”

Section: Discussionmentioning

confidence: 99%

A Fatal Case of a Ruptured Cerebral Aneurysm Detected by Postmortem Computed Tomography Angiography Using a New Contrast-Medium Solution

Stamou

Gascho

Eggert

et al. 2016

Am J Forensic Med Pathol

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Forensic autopsy is still the criterion standard in legal investigations. Currently, notable transformation is occurring because postmortem imaging is being increasingly endorsed. This article highlights the effectiveness of postmortem computed tomography angiography by using a new contrast medium mixture as a solitary tool to define the cause and manner of death in a ruptured cerebral aneurysm case. Based on the imaging results, autopsy was not mandated and the case was closed. Abstract: Forensic autopsy is still the criterion standard in legal investigations. Currently, notable transformation is occurring because postmortem imaging is being increasingly endorsed. This article highlights the effectiveness of postmortem computed tomography angiography by using a new contrast medium mixture as a solitary tool to define the cause and manner of death in a ruptured cerebral aneurysm case. Based on the imaging results, autopsy was not mandated and the case was closed.

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Section: Discussionmentioning

confidence: 99%

A Fatal Case of a Ruptured Cerebral Aneurysm Detected by Postmortem Computed Tomography Angiography Using a New Contrast-Medium Solution

Stamou

Gascho

Eggert

et al. 2016

Am J Forensic Med Pathol

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“…Postmortem whole-body MRI has overall high sensitivity for depicting soft-tissue lesions. Using postmortem MRI with ancillary investigations has now been shown to be as accurate as conventional autopsy in fetuses, newborns, and infants [3]. It is particularly useful for cerebral, cardiac, and genitourinary imaging.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Digital Autopsy: Popular Tools for an Unpopular Procedure

Islam¹,

Khan²,

Ikematsu³

et al. 2018

AJFSFM

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Digital autopsy is the future of postmortem examination of the human body through digital visualization. Imaging modalities such as CT scanners and MRI scanners use Xrays and magnetic fields to visualize the structures within the human body. The outputs from these modalities are obtained in a DICOM (Digital Imaging and Communications of Medicine) format. They are in gray-scale consisting of information in every slice taken during the scan. This is rendered and visualized as the full body in a digital format during the digital autopsy procedure. The visualization rendering produces a three-dimensional body, further presented in colour format based on each structure of the human organ system. Digital autopsy is a technology which allows pathologists to navigate and explore deeper into the human body. It allows analysis to be done in both two-dimensional and threedimensional perspectives. Digital autopsy involves analysis of human pathology and anatomical findings for diagnostic purposes. It can also be used for education and research purposes. Another advantage of digital autopsy is the availability of information and data that can be easily and securely transferred to a different digital autopsy facility at a different location. Thus, digital autopsy provides an efficient, fast, cheaper and accurate post-mortem data enabling a forensic pathologists to play a more effective role in the criminal justice system. DICOMThe images from all modalities and medical imaging devices are stored as DICOM files. DICOM is not only a file format but also a pervasive standard containing pro- The intensity in almost all modality outputs is monochrome, mainly in gray (black and white). These values were mapped to real tissues of the human body in Hounsfield units (HU) [7]. In addition, a set of default measurements defined by Sir Godfrey N Hounsfield for CT scanners is available for matching and viewing these organs and tissues ( Table-1). Digital Autopsy Visualization Three-Dimension (3D) VisualizationThe most important technique to transform layers of CT image data into 3D images (models) is the rendering technique comprising the following three steps [8]:

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“…In adults, multiphase postmortem whole-body CT angiography is now widely used as the first-line investigation, 1,2 but post-mortem MRI (PMMR) is becoming the accepted modality of choice following foetal and perinatal deaths. 3,4 The correct acquisition, interpretation and reporting of such images becomes increasingly important as more practitioners begin to develop and provide these services. Although the diagnostic accuracy of perinatal PMMR in general has been shown to be high following specialist interpretation, 5 PMMR is prone to errors, made by misinterpretation of normal PM changes and PM artefacts as pathology, and vice versa.…”

Section: Introductionmentioning

confidence: 99%

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

Norman¹,

Jawad²,

Jones³

et al. 2016

BJR

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As post-mortem MRI (PMMR) becomes more widely used for investigation following perinatal and paediatric deaths, the best possible images should be acquired. In this article, we review the most widely used published PMMR sequences, together with outlining our acquisition protocol and sequence parameters for foetal, perinatal and paediatric PMMR. We give examples of both normal and abnormal appearances, so that the reader can understand the logic behind each acquisition step before interpretation, as a useful day-to-day reference guide to performing PMMR.

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

Cited by 59 publications

References 46 publications

A Fatal Case of a Ruptured Cerebral Aneurysm Detected by Postmortem Computed Tomography Angiography Using a New Contrast-Medium Solution

A Fatal Case of a Ruptured Cerebral Aneurysm Detected by Postmortem Computed Tomography Angiography Using a New Contrast-Medium Solution

Digital Autopsy: Popular Tools for an Unpopular Procedure

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

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