NONINVASIVE PERINATAL NECROPSY BY MAGNETIC-RESONANCE-IMAGING

Background At present necropsy is done in less than 60% of cases of pe rinatal death in the UK, despite the value of the procedure to the ber eaved parents and their doctors. This low rate reflects the difficulty in discussing the examination during the acute distress after the dea th of a baby, and the personal and religious objections of many parent s to necropsy. We compared post-mortem magnetic resonance imaging (MRI ) of the fetus with internal perinatal necropsy to assess whether MRI examination is a feasible option for the 40% of cases where consent fo r necropsy is not given or requested. Methods We examined 20 stillborn , miscarried, or aborted fetuses by MRI and necropsy. Scanning was don e in a 1 . 5 T system, in accordance with our protocol, immediately be fore necropsy, The MRI and necropsy findings were compared to assess h ow much diagnostic information was obtained by each technique. Finding s In eight of the 20 cases the two examinations were in total agreemen t about the abnormalities present. In eight cases the necropsy provide d more detailed information than MRI examination, but in four cases th e MRI information was more extensive than that obtained at necropsy. I n two of the latter cases, abnormalities of the central nervous system were seen only on MRI, Thus, in 12 (60%) of the 20 cases studied, MRI had equivalent or better diagnostic sensitivity than internal necrops y examination; in 18 (90%) of the 20 cases the two examinations were o f similar clinical significance. Interpretation MRI of the stillborn o r aborted fetus provides non-invasive access to information previously available only from necropsy.