Radiological imaging of teratological fetuses: what can we learn?

Abstract

ObjectivesTo determine the advantages of radiological imaging of a collection of full-term teratological fetuses in order to increase their scientific and educational value.BackgroundAnatomical museums around the world exhibit full-term teratological fetuses. Unfortunately, these museums are regularly considered as “morbid cabinets”. Detailed dysmorphological information concerning the exhibited specimens is often lacking. Moreover, fetuses with severe and complex congenital anomalies are frequently diagnosed incompletely, incorrectly or not at all. MethodsIn order to verify diagnoses and to enrich their educational and scientific value, we imaged 41 out of the 72 teratological specimens present in the collection of our Anatomy and Pathology Museum in Nijmegen (The Netherlands) by means of magnetic resonance imaging (MRI) and computed tomography (CT). Additionally, contemporary dysmorphological insights and 3D models are implemented in the teratology education of medical students and residents.ConclusionsFull-term teratological fetuses have become increasingly rare and deserve a prominent place in every anatomical museum; they are suitable for contemporary teratological research and education. Modern radiological techniques markedly enhance their scientific and didactic value.Teaching Points• To explore the scientific and educational potential of institutionalised teratological collections • To understand the additional value of radiological imaging in diagnosing teratological specimens • To learn about the specific settings of MRI parameters when scanning fixed specimens • To recognise specific internal dysmorphology in several congenital anomalies

Sirenomelia: A Multi‐systemic Polytopic Field Defect with Ongoing Controversies

“…Our sirenomelic fetus was scanned with high‐resolution radiological techniques (Boer et al, ) and comprehensively described, according to modern dysmorphological insights (Gorlin et al, ; Hall, ). A short external and internal dysmorphological description is summarized.…”

Characterizing the coalescence area of conjoined twins to elucidate congenital disorders in singletons

“…Throughout many decades or even centuries of collecting, it is inherent in these collections that many specimens of the same type are brought together, making it possible to research and describe rare anomalies without the N = 1 problem common in a clinical setting. In addition to their substantial numbers, most of these representatives of the past were collected long before pre‐natal diagnostics became available (Boer, Schepens‐Franke, et al, 2017 ). This is why these specimens are often near or at full term, revealing unique insights into severe defects at a late stage of development.…”

A parapagus dicephalus tripus tribrachius conjoined twin with a unique morphological pattern: a case report

“…This is not the first time radiological imaging was used as a noninvasive method to increase insight into the internal dysmorphology of a teratological fetus. Boer et al used an approach similar to ours, in which 41 teratological specimens underwent both full-body CT and MRI [1]. With the wide availability of prenatal screening, most congenital anomalies are detected early in pregnancy, often resulting in termination [15].…”

“…Many anatomy and pathology departments possess valuable teratological specimens. However, due to lack of detailed external and internal (dys)morphological descriptions and proper diagnoses, these collections are sometimes stigmatized as "morbid cabinets" and not always used to their full scientific and educational potential [1]. Conjoined twins are often found among these collections.…”