Abstract

Central nervous system (CNS) abnormalities cause approximately 32–37.7% of terminations of pregnancy (TOP). Autopsy is currently the gold standard for assessing dead foetuses and stillborn. However, it has limitations and is sometimes subject to parental rejection. Recent studies have described post-mortem foetal magnetic resonance imaging (MRI) as an alternative and even complementary to autopsy for CNS assessment. Radiologists now play a key role in the evaluation of perinatal deaths. Assessment of foetal CNS abnormalities is difficult, and interpretation of foetal studies requires familiarisation with normal and abnormal findings in post-mortem MRI studies as well as the strengths and limitations of the imaging studies. The purpose of this pictorial review is to report our experience in the post-mortem MRI evaluation of the CNS system, including a description of the protocol used, normal CNS findings related to post-mortem status, abnormal CNS findings in our sample, and the correlation of these findings with histopathological results.

Highlights

  • Perinatal losses due to unexplained intrauterine deaths or foetal abnormalities or maternal disease are devastating in routine obstetric practice

  • It is essential to be aware of some specific “normal” imaging characteristics in post-mortem magnetic resonance imaging (MRI) in order to avoid misdiagnosis

  • Some series report that central nervous system (CNS) abnormalities cause approximately 32–37.7% of terminations of pregnancy (TOP) [3, 4]

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Summary

Key points

While invasive autopsy is currently the gold standard to evaluate foetuses and stillborn post-mortem, it has some important limitations. Post-mortem MRI is useful for the assessment of CNS abnormalities. It is essential to be aware of some specific “normal” imaging characteristics in post-mortem MRI in order to avoid misdiagnosis. There is high overall concordance between postmortem MRI and autopsy in detecting foetal and stillborn CNS abnormalities and, MRI may

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