Post mortem pathologic examination is declining worldwide due to emotional and religious factors. The British chief medical officer recently recommended that post mortem MRI examination should be explored as an alternative. The inevitable ischemic decay after death of biological tissue present various challenges for obtaining adequate contrast using regular neonatal MRI sequences.
The aims of the present study are to explore the various challenges of post mortem MRI examination after neonatal death and to assess its clinical yield.
Corpses of neonates were included in the study if they were lifeborns and died before discharge prior to 3 months of age in the neonatal unit. Informed consent was obtained from the parents.
Corpses were kept at 4○C until the scan. The examination consisted of the following sequences: T1W, T2W, FLAIR, SWI, DWI for the brain and T2W for the thorax and abdomen.
During the study period (28/8/14 TO 22/12/14) 83 neonates fulfilled the inclusion crieteria, of them 17 parents agreed to participate in the study and 10 were actually scanned. Range of gestational age at birth was 24041 weeks, age of death ranged 1 hour to 46 days (median 3 days), time to scan ranged 4-40 hours after death (mean12 hours). Main causes of death were prematurity related (4 cases), Congenital malformations (4 cases), HIE (1 case), sepsis (1 case).
Technical and human challenges in performing post mortem MRI scans will be discussed. Representative scans will be presented and differences between pre and post mortem imaging will be reported and discussed.
