Department of Radiology, Nemours Children's Health, 1600 Rockland Road, Wilmington, DE, 19803, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Pediatr Radiol. 2023 May;53(6):1135-1143. doi: 10.1007/s00247-023-05586-w. Epub 2023 Feb 2.
Postmortem imaging is used more widely as the number of conventional autopsies has decreased over the last several decades. It is widely accepted in Europe, Asia and Oceania, but there has been a delay in acceptance in North America. Education, scanning protocols, resourcing and clinical incentives are needed to support this emerging field.
To determine the use of postmortem imaging and define perceived barriers to its implementation with the goal of expanding postmortem imaging in the United States and Canada.
We sent an online survey to active members of the Society for Pediatric Radiology (SPR) addressing the use of postmortem imaging, indications, readers, practical aspects, anticipated barriers and potential solutions to more widespread use.
More than 50% of the 50 institutions that returned surveys used postmortem computed tomography; 24% used postmortem magnetic resonance imaging. Most postmortem imaging cases were read by radiologists. Fewer than 50% had formal correlation with autopsy results or an established relationship with the local medical examiner. Seven institutions reported reimbursement for postmortem imaging. Major barriers to postmortem imaging included lack of funding and lack of interest among clinicians. Funding and education were seen as important issues requiring attention.
While most responding institutions provide pediatric postmortem imaging, the modalities, protocols, reporting procedures and clinical correlation vary widely. A lack of funding and few opportunities for education are limiting factors. Attention to these issues along with active support from the SPR are seen as potential solutions to recognize the value and promote widespread acceptance of postmortem imaging.
随着过去几十年常规尸检数量的减少，死后成像的应用越来越广泛。它在欧洲、亚洲和大洋洲被广泛接受，但在北美却迟迟未被接受。教育、扫描方案、资源和临床激励措施都需要支持这个新兴领域。
确定死后成像的使用情况，并确定实施该技术的障碍，旨在扩大美国和加拿大的死后成像应用。
我们向活跃于儿科放射学会（SPR）的成员发送了一份在线调查，内容涉及死后成像的使用情况、适应症、读者、实际方面、预期障碍以及更广泛应用的潜在解决方案。
返回调查的 50 家机构中，超过 50%的机构使用了死后计算机断层扫描；24%的机构使用了死后磁共振成像。大多数死后成像病例由放射科医生解读。不到 50%的机构与尸检结果进行了正式的对比，或与当地法医建立了固定的联系。有 7 家机构报告对死后成像进行了报销。死后成像的主要障碍包括缺乏资金和临床医生缺乏兴趣。资金和教育被认为是需要关注的重要问题。
虽然大多数参与调查的机构都提供儿科死后成像，但成像方式、方案、报告程序和临床相关性差异很大。缺乏资金和很少有教育机会是限制因素。关注这些问题以及 SPR 的积极支持，被认为是认识到死后成像的价值并促进其广泛接受的潜在解决方案。
