Abstract | Keywords | Export | Availability | Bookmark

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Objectives To investigate the correlation between the grade of maceration, timing intervals between fetocide and scan, gestational age and the feasibility of DTI tractography of the corpus callosum (CC), bilateral corticospinal tract (TCS) and germinal matrix (GM) and their respective fractional anisotropy (FA) values as part of the postmortem Magnetic Resonance (MR) examination.. Methods All postmortem magnetic resonance scans between June 2017 and December 2018 performed on a 3 Tesla MR system were reviewed. Selected fetuses were delivered after termination of pregnancy (TOP) for severe fetal abnormalities. No postmortem fixation was carried out prior to MR. Whole body MR, including a DTI-sequence (60 directions, max 1300 b-value) of the brain, was performed with a maximum time interval of 24 hours. Maceration was graded using the Montaldo scoring system. Philips IntelliSpace Portal software (Best, The Netherlands) was used for DTI tractography and measurements. Results Forty fetuses were delivered at mean gestational age (GA) of 25 weeks (w) 6 days (d) (range: 16w 4d - 33w 5d). Eighteen fetuses scored 0 on maceration score (MaS) (45%), 15 MaS 1 (37.5%) and 7 MaS 2 (17.5). The CC, TCS (right (R) and left (L)) and GM (R and L) could be tracked in 26 fetuses. In 10 fetuses DTI-tracking of one or more tracks was impossible due to interfering pathology. Only in four fetuses, the tracking of one or two tracks was impossible without an apparent reason; these had a MaS of 1 or 2. No significant correlation of MaS, time between expulsion and scan, nor time between feticide and scan on the FA was found. In the twenty six fetuses with complete tractograpy, fractional anisotropy (FA) of the tracts decreased significantly with increasing GA (p-values ranging from <0.001 – 0.019). Conclusion In this postmortem MR study using non-fixed fetuses, the feasibility of DTI was demonstrated when the tracts were free of pathology and maceration. Furthermore, a significant decrease in FA of the CC, TCS and GM bilaterally with increasing gestational age was demonstrated