Post-mortem high-field magnetic resonance imaging: effect or various factors

Area of Science:

• Medical Imaging
• Fetal Pathology
• Post-mortem Examination

Background:

• Conventional post-mortem (PM) examination may be declined by parents for ethical or religious reasons.
• Fetal MRI offers a non-invasive imaging alternative for investigating fetal anomalies.
• Evaluating the efficacy of post-mortem MRI (PM-MRI) in early gestation is crucial for its clinical application.

Purpose of the Study:

• To assess the image quality and diagnostic accuracy of high-field PM-MRI in fetuses less than 20 weeks gestation.
• To compare image quality and diagnostic performance before and after the freeze-thaw process.
• To determine the reliability of PM-MRI as an alternative to conventional autopsy for early-gestation fetuses.

Main Methods:

• Nine fetuses (12.0-19.6 weeks gestation) underwent PM-MRI using three scanning protocols: fresh, non-fresh short scan, and non-fresh long scan after freezing at -20°C.
• Image quality was evaluated for the brain, thorax, heart, and abdomen.
• Diagnostic accuracy was assessed, and regression analysis identified factors influencing image quality.

Main Results:

• Better image quality was associated with later gestational age and scanning fresh fetuses.
• PM-MRI was consistently diagnostic for the fetal brain, regardless of the scanning protocol.
• Diagnostic accuracy for thoracic and abdominal structures was comparable between fresh and frozen fetuses, exceeding 50% for non-fresh scans.

Conclusions:

• High-field PM-MRI is a reliable alternative to conventional autopsy for fetuses under 20 weeks gestation.
• The technique demonstrates good diagnostic accuracy for fetal structures, even after the freeze-thaw process.
• PM-MRI offers a valuable option for parents who decline traditional post-mortem examinations.