Published online by Cambridge University Press: 05 September 2014
Introduction
Imaging assists the pathologist to visualize abnormalities that may not be evident to direct inspection. Post mortem imaging should be performed on all children where there is any suspicion about the cause of death (coronial or medical examiner request); in neonatal death; intrauterine fetal death; and termination of pregnancy for fetal abnormalities. Forensic autopsies may be performed with parental consent or as directed by the coroner (or equivalent legal officer).
The most common imaging modality is plain radiography. This can be performed either in the autopsy suite or using more specialized techniques. Most pediatric pathology departments have a dedicated imaging device, which uses low kilo-voltage (kV) X-rays to achieve maximum contrast and special imaging plates to achieve good spatial resolution and contrast on small specimens. For the larger fetus and in infants or children, plain radiography is performed by moving the body to the imaging department or alternatively using a portable machine in the autopsy room.
Imaging can assist the pathologist in diagnosis and guiding selective resection of bones followed by specimen radiography and then histopathological assessment.
More recently post mortem ultrasound (US), computed tomography (CT), or magnetic resonance (MR) scanning may allow further assessment and selective biopsy or restricted autopsy [1]. This is particularly useful in children whose parents have reservations about full autopsy. In the future “virtual autopsy” may be feasible. However, currently there are few detailed studies and experience in the clinical setting is limited.
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