Pediatric Post mortal Body Imaging at Safra Children`s Hospital – our 5 Year Experience

Aviva Ben Shlush Galit Zlotnik Lisa Raviv-Zilka Jeffery Jacobson michalle Soudack
Diagnostic Imaging, Edmond and Lily Safra Children's Hospital Chaim Sheba Medical Center, Tel Hashomer, Israel, Sackler School of Medicine, Tel-Aviv University, Israel

BACKGROUND: Virtual autopsy is an increasingly used noninvasive method to investigate undetermined cause of death in children. Whole body computerized tomography (CT) is used primarily and magnetic resonance imaging (MRI) is gaining recognition in this field.

PURPOSE: The purpose of this presentation is to present the post-mortal imaging workflow at the Safra Children's Hospital, and to share the findings and conclusions from our experience.

MATERIAL AND METHODS : From February 2013 to May 2018, 21 children underwent whole body post mortem CT. One child also had a whole body MRI. Exclusion criteria included patients with congenital cardiovascular anomalies.
Imaging protocols and findings were retrospectively reviewed for all cases. Findings were interpreted as normal post mortal or as pathologic.
An autopsy was available for correlation for one patient.

RESULTS: The study group included 20 patients ages 1day to 3years and 9 months.
For all Clinical information included suspected SIDS (sudden infant death syndrome),12; congenital lung malformation, 2; 1 each congenital neck mass, suspected non-accidental trauma (NAT), pneumonia, brain hemorrhage, immune deficiency and motor vehicle injury. Two children had undergone continued resuscitation for 4 days until death was confirmed.
Interpretation process: For all cases, the interpretation process included knowledge and correlation with the clinical course.
Post mortal imaging results: The most common finding were lung and airway abnormalities (n=17), followed by brain pathology (n=3).

Virtual autopsy is becoming an important diagnostic tool for a child without a known cause for death. Pediatric radiologists should be familiar with both normal post-mortem changes and the pathologies that imaging can diagnose.