Minimally invasive autopsy

Abstract

Post-mortem imaging is not a new process. Radiography has been used for years, and in the past few decades CT has been used, although mainly for forensic cases. With the decline in the rates of autopsy internationally, interest in imaging techniques has increased, leading to a minimally invasive autopsy procedure. Fetal, infant, and adult post-mortem MRI was first reported in 1990. 1 Ros PR Li KC Vo P Baer H Staab EV Preautopsy magnetic resonance imaging: initial experience. Magn Reson Imaging. 1990; 8: 303-308 Summary Full Text PDF PubMed Scopus (80) Google Scholar More detailed reports in 1996 2 Brookes JA Hall-Craggs MA Sams VR Lees WR Non-invasive perinatal necropsy by magnetic resonance imaging. Lancet. 1996; 348: 1139-1141 Summary Full Text Full Text PDF PubMed Scopus (149) Google Scholar and 1997 3 Woodward PJ Sohaey R Harris DP et al. Postmortem fetal MR imaging: comparison with findings at autopsy. AJR Am J Roentgenol. 1997; 168: 41-46 Crossref PubMed Scopus (123) Google Scholar , 4 Brookes JS Hall-Craggs MA Postmortem perinatal examination: the role of magnetic resonance imaging. Ultrasound Obstet Gynecol. 1997; 9: 145-147 Crossref PubMed Scopus (30) Google Scholar further delineated the advantages of this technique. In these studies, 3 Woodward PJ Sohaey R Harris DP et al. Postmortem fetal MR imaging: comparison with findings at autopsy. AJR Am J Roentgenol. 1997; 168: 41-46 Crossref PubMed Scopus (123) Google Scholar , 4 Brookes JS Hall-Craggs MA Postmortem perinatal examination: the role of magnetic resonance imaging. Ultrasound Obstet Gynecol. 1997; 9: 145-147 Crossref PubMed Scopus (30) Google Scholar macroscopic morphological changes at autopsy were compared with those seen during imaging. Since then, the potential value of the imaging process and its difficulties have been shown in further investigations. These studies include MRI of the small or severely macerated fetus in which the lack of inherent contrast between the tissues and the small size of the fetus requires a technique that provides good spatial resolution. Technical solutions to these difficulties have included use of small coils—eg, the wrist coil, 1·5 T MRI scanner, or saline bags in the coil adjacent to the fetus. 5 Whitby EH Paley MN Cohen M Griffiths PD Postmortem MR imaging of the fetus: an adjunct or a replacement for conventional autopsy?. Semin Fetal Neonatal Med. 2005; 10: 475-483 Summary Full Text Full Text PDF PubMed Scopus (53) Google Scholar Post-mortem examination of human fetuses: a comparison of whole-body high-field MRI at 9·4 T with conventional MRI and invasive autopsyWhole-body high-field MRI is a feasible option for post-mortem examination of human fetuses, and can provide good tissue characterisation even in small fetuses (5 g). The use of MRI at 9·4 T might be helpful in the development of a minimally invasive perinatal autopsy system. Full-Text PDF Open Access