Non-invasive perinatal necropsy by magnetic resonance imaging
Non-invasive perinatal necropsy by magnetic resonance imaging
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DOI：
10.1016/s0140-6736(96)02287-8
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发表时间：
1996-10-26
期刊：
影响因子：
168.9
通讯作者：
Lees, WR
中科院分区：
文献类型：
--
作者：
Brookes, JAS;HallCraggs, MA;Lees, WR
背景 目前，在英国，只有不到 60% 的围产期死亡病例需要进行尸检，尽管尸检对于失去亲人的父母及其医生很有价值。这种低比率反映出在婴儿死亡后的急性痛苦期间讨论检查的困难，以及许多父母个人和宗教上对尸检的反对。我们将胎儿的尸检磁共振成像 (MRI) 与围产期内部尸检进行比较，以评估 MRI 检查对于 40% 未给予或要求尸检同意的病例是否是可行的选择。 方法 我们通过 MRI 和尸检检查了 20 名死产、流产或流产的胎儿。扫描在 1 中完成。 5 T 系统，根据我们的方案，在尸检前立即比较 MRI 和尸检结果，以评估每种技术获得了多少诊断信息。结果 在 20 例中的 8 例中，两种检查对存在的异常情况完全一致。在 8 个病例中，尸检提供了比 MRI 检查更详细的信息，但在 4 个病例中，MRI 信息比尸检获得的信息更广泛。在后两个病例中，中枢神经系统的异常仅在 MRI 上可见。因此，在所研究的 20 例病例中，有 12 例 (60%) MRI 具有与内部尸检相同或更好的诊断灵敏度；在 20 例病例中，有 18 例 (90%) 的两项检查具有相似的临床意义。 死产或流产胎儿的 MRI 解释可以非侵入性地获取以前只能通过尸检获得的信息。
Background At present necropsy is done in less than 60% of cases of perinatal death in the UK, despite the value of the procedure to the bereaved parents and their doctors. This low rate reflects the difficulty in discussing the examination during the acute distress after the death of a baby, and the personal and religious objections of many parents 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 for necropsy is not given or requested.Methods We examined 20 stillborn, miscarried, or aborted fetuses by MRI and necropsy. Scanning was done in a 1 . 5 T system, in accordance with our protocol, immediately before necropsy, The MRI and necropsy findings were compared to assess how much diagnostic information was obtained by each technique.Findings In eight of the 20 cases the two examinations were in total agreement about the abnormalities present. In eight cases the necropsy provided more detailed information than MRI examination, but in four cases the MRI information was more extensive than that obtained at necropsy. In 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 necropsy examination; in 18 (90%) of the 20 cases the two examinations were of similar clinical significance.Interpretation MRI of the stillborn or aborted fetus provides non-invasive access to information previously available only from necropsy.