Hyde Georgia, Fry Andrew, Raghavan Ashok, Whitby Elspeth
Academic Unit of Reproductive and Developmental Medicine, The University of Sheffield, Sheffield, UK.
Medical Imaging and Medical Physics, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Sheffield, UK.
Acta Radiol Open. 2020 Nov 19;9(11):2058460120970541. doi: 10.1177/2058460120970541. eCollection 2020 Nov.
Less invasive techniques for fetal post-mortems are increasingly used to correlate with parental wishes. With the use of post-mortem magnetic resonance imaging (MRI), normal appearance of the organs must be established.
To investigate the after death appearance of the fetal meconium throughout gestation using the hyperintense appearance of meconium on T1 weighted MRI.
This was a retrospective study that took place in a tertiary referral centre radiology department. Sixty-two fetal body post-mortem MRI scans (January 2014 to May 2018) between 12 and 41 weeks gestation were reviewed. Signal intensity of meconium at the rectum, sigmoid colon, splenic flexure and hepatic flexure was evaluated and correlated with gestational age. Interrater reliability was calculated.
Meconium did not consistently have high signal intensity on T1 scans and was not always obvious. Rectal meconium had the highest intensity, and the more proximal the bowel the lower the intensity. The meconium had higher intensity at earlier gestations. Interrater reliability for rectal meconium gradings was excellent.
This study provides the first published primary research on the appearance of fetal meconium on post-mortem MRI. Overall, results were variable and suggest an alteration of bowel contents after death, but further investigation is needed to effectively inform practice.
用于胎儿尸检的侵入性较小的技术越来越多地被用于与父母的意愿相匹配。通过使用尸检磁共振成像（MRI），必须确定器官的正常外观。
利用T1加权MRI上胎粪的高信号表现，研究整个孕期胎儿胎粪死后的表现。
这是一项在三级转诊中心放射科进行的回顾性研究。回顾了2014年1月至2018年5月期间62例妊娠12至41周的胎儿尸体尸检MRI扫描。评估直肠、乙状结肠、脾曲和肝曲处胎粪的信号强度，并与孕周进行关联。计算了评估者间的可靠性。
胎粪在T1扫描上并非始终具有高信号强度，且并不总是明显可见。直肠胎粪的信号强度最高，肠道越靠近近端信号强度越低。胎粪在妊娠早期信号强度较高。直肠胎粪分级的评估者间可靠性极佳。
本研究首次发表了关于胎儿胎粪在尸检MRI上表现的初步研究。总体而言，结果存在差异，提示死后肠道内容物发生了改变，但需要进一步研究以有效地为实践提供参考。
