Cohen Marta C, Whitby Elspeth, Fink Michelle A, Collett Jacquelene M, Offiah Amaka C
Academic Unit of Child Health, Sheffield Children's NHS Foundation Trust, University of Sheffield, Western Bank, Sheffield, S10 2TH, UK.
Pediatr Radiol. 2015 Apr;45(4):501-8. doi: 10.1007/s00247-014-3156-0. Epub 2015 Apr 1.
The purpose of the postmortem examination is to offer answers to explain the cause and manner of death. In the case of perinatal, infant and paediatric postmortem examinations, the goal is to identify unsuspected associated features, to describe pathogenic mechanisms and new conditions, and to evaluate the clinical management and diagnosis. Additionally, the postmortem examination is useful to counsel families regarding the probability of recurrence in future pregnancies and to inform family planning. Worldwide the rate of paediatric autopsy examinations has significantly declined during the last few decades. Religious objections to postmortem dissection and organ retention scandals in the United Kingdom provided some of the impetus for a search for non-invasive alternatives to the traditional autopsy; however, until recently, imaging studies remained an adjunct to, rather than a replacement for, the traditional autopsy. In 2012, Sheffield Children's Hospital National Health Service Foundation Trust set up the service provision of minimally invasive fetal, perinatal and neonatal autopsy, while a postmortem imaging service has been running in Melbourne, Australia, since 2008. Here we summarise the essentials of a business case and practical British and Australian experiences in terms of the pathological and radiologic aspects of setting up a minimally invasive clinical service in the United Kingdom and of developing a clinical postmortem imaging service as a complementary tool to the traditional autopsy in Australia.
尸检的目的是提供答案以解释死亡原因和方式。在围产期、婴儿及儿科尸检中，目标是识别未被怀疑的相关特征，描述致病机制和新情况，并评估临床管理和诊断。此外，尸检有助于就未来妊娠复发的可能性为家庭提供咨询，并为计划生育提供信息。在过去几十年里，全球儿科尸检率显著下降。英国宗教对尸检解剖和器官留存丑闻的反对为寻找传统尸检的非侵入性替代方法提供了一些动力；然而，直到最近，影像学研究仍然是传统尸检的辅助手段，而非替代品。2012年，谢菲尔德儿童医院国民保健服务基金会信托机构设立了微创胎儿、围产期和新生儿尸检服务，而自2008年以来，澳大利亚墨尔本一直在运行尸检成像服务。在此，我们从病理和放射学方面总结了商业案例的要点以及英国和澳大利亚在英国建立微创临床服务以及在澳大利亚开发临床尸检成像服务作为传统尸检补充工具的实际经验。
