Post-mortem MR and CT imaging in fetuses, newborns and children: an evidenced based approach

Abstract There is insufficient evidence in the published literature to support the use of post-mortem MR imaging (MRI) as an alternative for conventional non-forensic autopsy in fetuses, newborns and children. Large prospective studies evaluating the accuracy of post-mortem MR imaging in a rigorous and blinded way are now nearing completion and the results are expected in 2011. Less-invasive autopsies by post-mortem MR imaging may have major effect in resurrecting consented autopsy rates; however an evidenced based and systematic approach towards less-invasive autopsy process is mandatory to ensure that the post-mortem data remains accurate and credible. Here we summarize the current evidence, ongoing research and future directions for less-invasive autopsy process in the United Kingdom. A joint effort between clinicians, radiologists, pathologists, parent groups and funding bodies is essential for successful implementation of less-invasive autopsy, in the UK.

[1]  F. Gallagher,et al.  Postmortem fetal organ volumetry using magnetic resonance imaging and comparison to organ weights at conventional autopsy , 2008, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[2]  W. Frankel,et al.  Laparoscopic postmortem examination: a minimally invasive approach to the autopsy. , 2000, Annals of diagnostic pathology.

[3]  T. Huisman,et al.  MR Autopsy in Fetuses , 2002, Fetal Diagnosis and Therapy.

[4]  Joachim Wirth,et al.  3D surface and body documentation in forensic medicine: 3-D/CAD Photogrammetry merged with 3D radiological scanning. , 2003, Journal of forensic sciences.

[5]  I. Joubert,et al.  Use of a confidence scale in reporting postmortem fetal magnetic resonance imaging , 2006, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[6]  D. Elder,et al.  Autopsy after death due to extreme prematurity , 2005, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[7]  Neil J Sebire,et al.  Post-mortem examination of human fetuses: a comparison of whole-body high-field MRI at 9·4 T with conventional MRI and invasive autopsy , 2009, The Lancet.

[8]  R. Bisset,et al.  Postmortem examinations using magnetic resonance imaging: four year review of a working service , 2002, BMJ : British Medical Journal.

[9]  Jerónimo Buencuerpo,et al.  Ultrasonographic autopsy (echopsy): a new autopsy technique , 2002, Virchows Archiv.

[10]  R. Boxer,et al.  Correlation between clinical diagnoses and autopsy findings in critically ill children. , 1993, Pediatrics.

[11]  Gabriel P Krestin,et al.  Minimally invasive autopsy: an alternative to conventional autopsy? , 2009, Radiology.

[12]  J. Dickinson,et al.  The role of autopsy following pregnancy termination for fetal abnormality , 2007, The Australian & New Zealand journal of obstetrics & gynaecology.

[13]  W. Lees,et al.  Non-invasive perinatal necropsy by magnetic resonance imaging , 1996, The Lancet.

[14]  E. Whitby,et al.  The use of magnetic resonance in the hospital and coronial pediatric postmortem examination , 2007, Forensic science, medicine, and pathology.

[15]  C. Hagmann,et al.  Postmortem magnetic resonance imaging as an adjunct to perinatal autopsy for renal-tract abnormalities , 2006, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[16]  D. Elder,et al.  Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses? , 2005, BJOG : an international journal of obstetrics and gynaecology.

[17]  A. Alexander,et al.  Postmortem fetal MR imaging: comparison with findings at autopsy. , 1997, AJR. American journal of roentgenology.

[18]  N. Scott,et al.  Guidelines for investigating stillbirths: an update of a systematic review. , 2007, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[19]  C. Lees,et al.  Feasibility of percutaneous organ biopsy as part of a minimally invasive perinatal autopsy , 2008, Virchows Archiv.

[20]  E. Tegnander,et al.  The examiner's ultrasound experience has a significant impact on the detection rate of congenital heart defects at the second‐trimester fetal examination , 2006, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[21]  J. Peringa,et al.  Perinatal mortality: clinical value of postmortem magnetic resonance imaging compared with autopsy in routine obstetric practice , 2003 .

[22]  M. Paley,et al.  Less Invasive Autopsy: Benefits and Limitations of the Use of Magnetic Resonance Imaging in the Perinatal Postmortem , 2008, Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society.

[23]  A. Bal,et al.  COMPARISION OF NEEDLE AUTOPSY WITH CONVENTIONAL AUTOPSY IN NEONATES , 2009, Fetal and pediatric pathology.

[24]  S. Phadke,et al.  Clinical utility of fetal autopsy and comparison with prenatal ultrasound findings , 2006, Journal of Perinatology.

[25]  P. Griffiths,et al.  Post-mortem MRI of the foetal spine and spinal cord. , 2006, Clinical Radiology.

[26]  W. Law,et al.  Multimodality minimally invasive autopsy--a feasible and accurate approach to post-mortem examination. , 2010, Forensic science international.

[27]  J. S. Lameris,et al.  The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review , 2009, European Radiology.

[28]  D. Figarella-Branger,et al.  Value of fetal autopsy after medical termination of pregnancy. , 2004, Forensic science international.

[29]  T. Jacques,et al.  Prospective parental consent for autopsy research following sudden unexpected childhood deaths: a successful model , 2009, Archives of Disease in Childhood.

[30]  N. Sebire,et al.  Parental consent for research and sudden infant death , 2008, The Lancet.

[31]  M. Başbuğ,et al.  Correlation between prenatal ultrasound and fetal autopsy findings in fetal anomalies terminated in the second trimester , 2007, Prenatal diagnosis.

[32]  E. Tegnander,et al.  Prenatal detection of heart defects in a non‐selected population of 30 149 fetuses—detection rates and outcome , 2006, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology.

[33]  C. O'Donnell,et al.  Post-mortem radiology--a new sub-speciality? , 2008, Clinical radiology.

[34]  R E Zumwalt,et al.  Postmortem cranial MRI and autopsy correlation in suspected child abuse. , 1996, The American journal of forensic medicine and pathology.

[35]  P. Antonsson,et al.  Comparison of ultrasound and autopsy findings in pregnancies terminated due to fetal anomalies , 2006, Acta obstetricia et gynecologica Scandinavica.

[36]  P. Saldiva,et al.  Comparison between clinical diagnoses and autopsy findings in a pediatric intensive care unit in São Paulo, Brazil* , 2006, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[37]  M. Paley,et al.  Postmortem MR imaging of the fetus: an adjunct or a replacement for conventional autopsy? , 2005, Seminars in fetal & neonatal medicine.

[38]  N. Sebire,et al.  Diagnostic accuracy of post-mortem magnetic resonance imaging in fetuses, children and adults: a systematic review. , 2010, European journal of radiology.

[39]  J. Catheline,et al.  Autopsy can be performed laparoscopically , 1999, Surgical Endoscopy.

[40]  I. Wilkinson,et al.  Postmortem MR imaging of the fetal and stillborn central nervous system. , 2003, AJNR. American journal of neuroradiology.

[41]  Silvia Schievano,et al.  A semi-automated method for non-invasive internal organ weight estimation by post-mortem magnetic resonance imaging in fetuses, newborns and children. , 2009, European journal of radiology.

[42]  F Foroudi,et al.  A Comparison Of The Needle Biopsy Post Mortem With The Conventional Autopsy , 1995, Pathology.

[43]  P. Cartlidge,et al.  Perinatal and infant autopsy , 2006, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[44]  K. Shojania,et al.  The vanishing nonforensic autopsy. , 2008, The New England journal of medicine.

[45]  R Avrahami,et al.  Laparoscopic vs conventional autopsy. A promising perspective. , 1995, Archives of surgery.

[46]  W R Lees,et al.  Magnetic resonance necropsy is offered routinely in University College London Hospitals , 1999, BMJ.