Abstract
Introduction: The use of diagnostic imaging in clinical and forensic autopsies, is a practice that is taking place in countries other than our own, especially in autopsies of particular difficulty such as fetuses and neonates. It is important to know the correlation between magnetic resonance imaging postmortem and clinical autopsy to recommend its routine use in our midst.
Materials and methods: Autopsies performed on 20 fetuses and neonates and took total body MRI thereof, comparing imaging findings with autopsy findings. Information obtained was tabulated and Kappa value was rated to determine the concordance between the two diagnostic methods.
Results:We calculated the correlation between MRI and clinical autopsy in detecting major malformations per system, calculating a kappa index for major malformations in the central nervous system of 0.273, for head and neck of 0.459, to the respiratory system of 0, for cardiovascular system from 0.459, for the gastrointestinal tract and the abdomen of 0, and urinary system of 0.643.
Conclusions: Despite the poor correlation between MRI and postmortem clinical autopsy in detecting major malformations is considered in this case to the clinical autopsy as an imperfect gold standard and recommended the use of magnetic resonance imaging study mode can support a clinical autopsy in detecting major malformations in difficult cases in fetuses and neonates.
Bilge Y, Kedici PS, Alakoç YD, et al. The identification of a dismembered human body: a multidisciplinary approach. Forensic Sci Int. 2003;137(2-3):141-6.
Byard RW, Both K, Simpson E. The identification of submerged skeletonized remains. Am J Forensic Med Pathol. 2008;29:69-71.
Abdel Moneim WM1, Abdel Hady RH, Abdel Maaboud RM, et al. Identification of sex depending on radiological examination of foot and patella. Am J Forensic Med Pathol. 2008;29:136-40.
Mincer HH, Chaudhry J, Blankenship JA, Turner EW. Postmortem dental radiography. J Forensic Sci. 2008;53:405-7.
Blau S, Robertson S, Johnstone M. Disaster victim identification: new applications for postmortem computed tomography. J Forensic Sci. 2008;53:956-60.
Scholing M, Saltzherr TP, Fung Kon Jin PH, et al. The value of postmortem computed tomography as an alternative for autopsy in trauma victims: a systematic review. Eur Radiol. 2009 Oct;19(10):2333.
Thali MJ, Schweitzer W, Yen K, et al. New horizons in forensic radiology: the 60-second digital autopsy-full body examination of a gunshot victim multislice computed tomography. Am J Forensic Med Pathol. 2003;24:22-7.
Harcke HT, Levy AD, Abbott RM, et al. Autopsy radiography: digital radiographs vs multidetector computed tomography in high-velocity gunshotwound victims. Am J Forensic Med Pathol. 2007;28:13-9.
Agayev E, Christe A, Sonnenschein M, et al. Postmortem imaging of blunt chest trauma using CT and MRI. J Thorac Imaging. 2008;23:20-7.
Christe A, Ross S, Oesterhelweg L, et al. Abdominal trauma-sensitivity and specificity of postmortem noncontrast imaging findings compared with autopsy findings. J Trauma. 2009;66:1302-7.
Bender M, Musolino PL, Rugilo C, et al. Normal anatomy of the developing fetal brain: ex vivo anatomical–magnetic resonance imaging correlation. J Neurol Sci. 2006;250:20-6.
Manzano AC, Morillo AJ, Vallejo JM, Bayona MP. Necropsy by magnetic resonance in a case of coinjoined thoracopagus twins. J Magn Reson Imaging. 2001;13:976-81.
Cha JG, Kim DH, Kim DH, et al. Utility of postmortem autopsy via whole-body imaging: initial observations comparing MDCT and 3.0 T MRI findings with autopsy findings. Korean J Radiol. 2010 Jul-Aug;11(4):395-406.
Dirnhofer R, Jackowski C, Vock P, et al. Virtopsy: minimally invasive, imaging guided virtual autopsy. Radiographics. 2006 Sep-Oct;26(5):1305-33.
Thali MJ, Drnhofer R, Vock P. The virtopsy approach. 1st ed. CRC Press; 2009.
Lichtenstein JE, Fitzpatrick JJ, Madewell JE. The role of radiology in fatality investigations. AJR Am J Roentgenol. 1988 Apr;150(4):751-5.
O’Donnell C, Woodford N. Post-mortem radiology--a new sub-speciality? Clin Radiol. 2008 Nov;63(11):1189-94.
Morayati SJ, Nagle CE. The determination of death and the changing role of medical imaging. Radiographics. 1988 Sep;8(5):967-79.
Sieswerda-Hoogendoorn T, van Rijn RR. Current techniques in postmortem imaging with specific attention to paediatric applications. Pediatr Radiol. 2010 Feb;40(2):141-52.
McGraw EP, Pless JE, Pennington DJ, Whit SJ. Postmortem radiography after unexpected death in neonates, infants, and children: should imaging be routine? Am J Roentgenol. 2002;178:1517-21.
Woodward PJ, Sohaey R, Harris DP, et al. Postmortem fetal MR imaging: comparison with findings at autopsy. AJR. 1997;168:41-6.
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