Postmortem examination of human fetal hearts at or below 20 weeks' gestation: a comparison of high‐field MRI at 9.4 T with lower‐field MRI magnets and stereomicroscopic autopsy

Abstract

Objectives To compare the diagnostic usefulness of highfield with low-field magnetic resonance imaging (MRI)and stereomicroscopic autopsy for examination of the heart in fetuses at or under 20 weeks' gestation. (95% CI,) and specificity 100. 0% (95% CI,. Eight fetuses out of 10 with congenital heart disease (CHD) were classified as having major CHD. Methods High-field MRI at 9.4 T was able to identify seven out of the eight cases of major CHD.Conclusion High-field MRI at 9.4 T seems to be an acceptable alternative approach to invasive stereomicroscopic autopsy for fetuses with CHD at or below 20 weeks' gestation.

Post-mortem whole-body magnetic resonance imaging of human fetuses: a comparison of 3-T vs. 1.5-T MR imaging with classical autopsy

“…Since a higher field strength is accompanied by an increase in signal-to-noise ratio, better spatial resolution and thus more detailed imaging of fetal anatomy, attempts to improve image quality and diagnostic accuracy for small fetuses have focused on the use of higher-field magnets such as 3-T or 9.4-T [10, [16][17][18]. In a study focusing on congenital heart defects (CHDs) including 24 fetuses at 11 to 20 weeks of gestation,…”

“…MR imaging was performed with 1.5-T, 3-T and 9.4-T magnets prior to classical autopsy [16]. While only the cardiac situs and four-chamber view could be visualized in 62% and 25% of cases for 1.5-T MR imaging and 70% and 45% of cases on 3-T MR imaging respectively when the fetus was below 20 weeks of gestation, using MR imaging at 9.4 T, the cardiac situs, four-chamber view and the outflow tracts could be visualized in all fetuses irrespective of gestational age.…”

“…However, few studies have considered its contribution to fetal post-mortem imaging [14][15][16][17][18] and we lack comparison with fetal whole-body post-mortem MR imaging at 1.5-T. 6 …”

Postmortem microcomputed tomography (micro‐CT) of small fetuses and hearts

“…Several groups have proposed alternatives to postmortem dissection, including virtual autopsy based on imaging modalities such as magnetic resonance imaging (MRI). While the resolution offered by scanners used for conventional whole‐body MRI in the clinical setting is too low for successful examination of first‐ and second‐trimester fetuses, more promising results have been obtained with high‐field (9.4‐T) micro‐MRI scanners designed for imaging small laboratory animals. Like all MRI‐based approaches, however, their use in a clinical setting is limited by cost, time and space constraints.…”

Review of Post-Mortem Invasive and Non-Invasive Methods to Study the Pathology of Great Vessels of Fetuses and Newborns

“…Однако, использование современных неинвазивных методов посмертного изу-чения, направленные на изучение строения ССС плодов, тоже находит отражение в литературе [14][15][16][17]. Sandaite et al [14] ис-пользовали МРТ аппарата мощностью 3 Тесла для анализа ССС без аномалий у плодов со сроком гестации от 13 до 38 не-дель.…”