Fetal necrogram: a new technique. Experience with 12,000 contrast examinations.

The authors describe a new technique "necrogram" for post-mortem fetal investigations that uses ionic contrast media and employs the principles of diffusion and osmosis for clearing the fetus from contrast injection. It was possible to perform subsequent contrast examinations without the problem of overlapping structures. The study was conducted on 1,500 fetuses with more than 12,000 contrast examinations performed, followed by autopsy. In a sample of 250 fetuses undergoing 2,135 contrast examinations, similar results were obtained from necrogram and autopsy in 79% of the fetuses examined. Details are given of the 21% of the studies in which discrepancies were noted between necrogram and autopsy. The result showed that necrogram was comparable to autopsy and that luminal anatomy can be best visualized by necrogram, a laborious and almost impossible task in autopsy. It was apparent that post-mortem diagnostic precision can only be obtained by employing both necrogram and autopsy, one for visualization of the inner and the other for the outer appearance of the organs.