Woodward P J, Sohaey R, Harris D P, Jackson G M, Klatt E C, Alexander A L, Kennedy A
Department of Radiology, University of Utah, Salt Lake City 84132, USA.
AJR Am J Roentgenol. 1997 Jan;168(1):41-6. doi: 10.2214/ajr.168.1.8976917.
The purpose of this study was to prospectively compare findings from postmortem fetal MR imaging with findings at autopsy.
Twenty-six fetuses were imaged on a 1.5-T MR scanner using two-dimensional and high-resolution three-dimensional fast spin-echo techniques immediately before autopsy. The MR images were reviewed independently by three radiologists who evaluated then for major and minor malformations. These findings were then compared with those at autopsy.
The 26 subjects had 47 major and 11 minor malformations. All three radiologists correctly identified 37 of the major malformations on the MR images (detection rate, 79%), and at least one of the three reviewers correctly identified 43 of the abnormalities (detection rate, 91%). Only one of the 11 minor anomalies was identified by any reviewer. Reviewers made six false-positive diagnoses. In two cases, both with major CNS malformations, MR imaging was superior to autopsy in defining in situ relationships.
Although autopsy remains the study of choice for evaluating causes of fetal death, MR imaging is an excellent alternative when autopsy is refused. Additionally, MR imaging may be a valuable adjunct to autopsy for fetuses with CNS anomalies.
本研究旨在前瞻性地比较胎儿尸体磁共振成像（MR成像）结果与尸检结果。
26例胎儿在尸检前即刻使用二维和高分辨率三维快速自旋回波技术在1.5-T MR扫描仪上进行成像。三位放射科医生独立审查MR图像，评估主要和次要畸形。然后将这些结果与尸检结果进行比较。
26例研究对象有47处主要畸形和11处次要畸形。三位放射科医生均在MR图像上正确识别出37处主要畸形（检出率79%），三位审查者中至少有一人正确识别出43处异常（检出率91%）。11处次要畸形中仅有1处被任何一位审查者识别出。审查者做出了6例假阳性诊断。在两例均为主要中枢神经系统畸形的病例中，MR成像在确定原位关系方面优于尸检。
虽然尸检仍是评估胎儿死亡原因的首选研究方法，但当拒绝尸检时，MR成像是一种极佳的替代方法。此外，对于有中枢神经系统异常的胎儿，MR成像可能是尸检的一种有价值的辅助手段。
