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Current techniques in postmortem imaging with specific attention to paediatric applications.

Sieswerda-Hoogendoorn T, van Rijn RR - Pediatr Radiol (2009)

Bottom Line: In this review we discuss the decline of and current controversies regarding conventional autopsies and the use of postmortem radiology as an adjunct to and a possible alternative for the conventional autopsy.We will address the radiological techniques and applications for postmortem imaging in children.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuid-Oost, Netherlands.

ABSTRACT
In this review we discuss the decline of and current controversies regarding conventional autopsies and the use of postmortem radiology as an adjunct to and a possible alternative for the conventional autopsy. We will address the radiological techniques and applications for postmortem imaging in children.

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Related in: MedlinePlus

A neonate aborted at 20 weeks gestational age. a Antenatal US showed a massively dilated bladder and bilateral hydronephrosis. Sagittal T2-W MRI shows a distended bladder (asterisk) and a dilated posterior urethra (open arrow), consistent with posterior urethral valves (slice thickness: 1 mm, TR: 1500, TE: 161, FA: 150°). Note the fluid-fluid level in the heart (arrow) as a result of blood b Coronal T2-W MRI shows a distended bladder (asterisk) and dilated tortuous ureters (open arrow). There is a substantial bilateral pyelocaliceal dilatation (arrow). There is a relative hypoplasia of the lungs as a result of the oligohydramnion
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Fig9: A neonate aborted at 20 weeks gestational age. a Antenatal US showed a massively dilated bladder and bilateral hydronephrosis. Sagittal T2-W MRI shows a distended bladder (asterisk) and a dilated posterior urethra (open arrow), consistent with posterior urethral valves (slice thickness: 1 mm, TR: 1500, TE: 161, FA: 150°). Note the fluid-fluid level in the heart (arrow) as a result of blood b Coronal T2-W MRI shows a distended bladder (asterisk) and dilated tortuous ureters (open arrow). There is a substantial bilateral pyelocaliceal dilatation (arrow). There is a relative hypoplasia of the lungs as a result of the oligohydramnion

Mentions: Obtaining permission for an examination of the brain during an autopsy can be especially difficult because it takes several weeks to fixate the brain properly, and many parents/guardians request that all organs be replaced before burial [40]. It is therefore encouraging that several studies have shown that structural anomalies of the brain can be adequately detected with MRI [26, 41]. Griffiths et al. [42] have been examining neuropathology in foetuses and deceased neonates since 2003. In their first series they found complete agreement between MRI and autopsy in 28 of 32 cases. In 2005 they examined more than 200 foetuses and neonates with similar results. They found that MR provides detailed information about all organ systems, except for the heart (Figs. 8 and 9) [13]. Cohen et al. [25] found that although MR is very good in detecting brain and spine anomalies, if it is not combined with the results of autopsy, 71% of essential information will not be detected. Breeze et al. [43] determined kappa values to assess agreement between MRI and autopsy for different organ systems. They were high for the brain (0.83), moderate for lungs (0.56) and fair for the heart (0.33). The relative inability of postmortem MRI to detect cardiac pathology is described by several other authors [43, 44]. This is a major shortcoming because cardiac disease is a major cause of death in the Western world.Fig. 8


Current techniques in postmortem imaging with specific attention to paediatric applications.

Sieswerda-Hoogendoorn T, van Rijn RR - Pediatr Radiol (2009)

A neonate aborted at 20 weeks gestational age. a Antenatal US showed a massively dilated bladder and bilateral hydronephrosis. Sagittal T2-W MRI shows a distended bladder (asterisk) and a dilated posterior urethra (open arrow), consistent with posterior urethral valves (slice thickness: 1 mm, TR: 1500, TE: 161, FA: 150°). Note the fluid-fluid level in the heart (arrow) as a result of blood b Coronal T2-W MRI shows a distended bladder (asterisk) and dilated tortuous ureters (open arrow). There is a substantial bilateral pyelocaliceal dilatation (arrow). There is a relative hypoplasia of the lungs as a result of the oligohydramnion
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2803260&req=5

Fig9: A neonate aborted at 20 weeks gestational age. a Antenatal US showed a massively dilated bladder and bilateral hydronephrosis. Sagittal T2-W MRI shows a distended bladder (asterisk) and a dilated posterior urethra (open arrow), consistent with posterior urethral valves (slice thickness: 1 mm, TR: 1500, TE: 161, FA: 150°). Note the fluid-fluid level in the heart (arrow) as a result of blood b Coronal T2-W MRI shows a distended bladder (asterisk) and dilated tortuous ureters (open arrow). There is a substantial bilateral pyelocaliceal dilatation (arrow). There is a relative hypoplasia of the lungs as a result of the oligohydramnion
Mentions: Obtaining permission for an examination of the brain during an autopsy can be especially difficult because it takes several weeks to fixate the brain properly, and many parents/guardians request that all organs be replaced before burial [40]. It is therefore encouraging that several studies have shown that structural anomalies of the brain can be adequately detected with MRI [26, 41]. Griffiths et al. [42] have been examining neuropathology in foetuses and deceased neonates since 2003. In their first series they found complete agreement between MRI and autopsy in 28 of 32 cases. In 2005 they examined more than 200 foetuses and neonates with similar results. They found that MR provides detailed information about all organ systems, except for the heart (Figs. 8 and 9) [13]. Cohen et al. [25] found that although MR is very good in detecting brain and spine anomalies, if it is not combined with the results of autopsy, 71% of essential information will not be detected. Breeze et al. [43] determined kappa values to assess agreement between MRI and autopsy for different organ systems. They were high for the brain (0.83), moderate for lungs (0.56) and fair for the heart (0.33). The relative inability of postmortem MRI to detect cardiac pathology is described by several other authors [43, 44]. This is a major shortcoming because cardiac disease is a major cause of death in the Western world.Fig. 8

Bottom Line: In this review we discuss the decline of and current controversies regarding conventional autopsies and the use of postmortem radiology as an adjunct to and a possible alternative for the conventional autopsy.We will address the radiological techniques and applications for postmortem imaging in children.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam Zuid-Oost, Netherlands.

ABSTRACT
In this review we discuss the decline of and current controversies regarding conventional autopsies and the use of postmortem radiology as an adjunct to and a possible alternative for the conventional autopsy. We will address the radiological techniques and applications for postmortem imaging in children.

Show MeSH
Related in: MedlinePlus