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Postmortem fetal MR imaging: comparison with findings at autopsy
P J Woodward1, R Sohaey, D P Harris
1Department of Radiology, University of Utah, Salt Lake City 84132, USA.
AJR. American Journal of Roentgenology
|January 1, 1997
Summary
Postmortem fetal MR imaging accurately detects major fetal malformations, offering a valuable alternative to autopsy when it is refused. This imaging technique can also complement autopsy for central nervous system anomalies.
Area of Science:
- Medical Imaging
- Radiology
- Fetal Medicine
Background:
- Autopsy is the traditional method for evaluating fetal deaths.
- Limitations exist in autopsy, particularly for subtle anomalies or when consent is withheld.
Purpose of the Study:
- To prospectively compare postmortem fetal magnetic resonance (MR) imaging findings with autopsy results.
- To assess the diagnostic accuracy of fetal MR imaging for detecting malformations.
Main Methods:
- Twenty-six fetuses underwent 1.5-T MR imaging using 2D and 3D fast spin-echo techniques before autopsy.
- Three radiologists independently reviewed MR images for major and minor malformations.
- MR findings were compared with subsequent autopsy diagnoses.
Main Results:
- A total of 47 major and 11 minor malformations were identified.
- Radiologists detected 79% of major malformations on MR images (37/47) and 91% (43/47) with at least one reviewer.
- Minor anomalies had low detection rates; six false-positive diagnoses were made.
- MR imaging demonstrated superiority over autopsy in defining in situ relationships for two central nervous system (CNS) malformations.
Conclusions:
- Postmortem fetal MR imaging is an excellent alternative when autopsy is refused.
- MR imaging can be a valuable adjunct to autopsy, especially for evaluating CNS anomalies.
- Autopsy remains the gold standard for determining the cause of fetal death.