Micro-computed tomography: a new diagnostic tool in postmortem assessment of brain anatomy in small fetuses
The aim of our study was to evaluate the postmortem micro-CT anatomy of early fetal human fetal brains, either in situ or isolated.
We studied 12 ex vivo specimens, 9 whole human fetuses (9–18 GW), and 3 isolated samples (16–26 GW).
Specimens were fixed in formalin, then immersed in Lugol solution. Images were evaluated by two neuroradiologists. The depiction of CNS structures was defined based on the comparison between micro-CT images and a reference histologic anatomical Atlas of human brain development.
Micro-CT provided informative high-resolution brain images in all cases, with the exception of one case (9 weeks) due to advanced maceration. All major CNS structures (i.e., brain hemispheres, layering, ventricles, germinal neuroepithelium, basal ganglia, corpus callosum, major cranial nerves, and structures of the head and neck) were recognizable.
Micro-CT imaging of the early fetal brain is feasible and provides high-quality images that correlate with the histological Atlas of the human brain, offering multiplanar and volumetric images that can be stored and shared for clinical, teaching, and research purposes.
KeywordsFetus Autopsy Neuroimaging Micro-focus computed tomography Postmortem imaging First trimester
Micro-focus computed tomography
Germinal neuroepithelium or zone
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
For this type of retrospective study formal consent is not required.
- 6.Arthurs OJ, Thayyil S, Pauliah SS, Jacques TS, Chong WK, Gunny R, Saunders D, Addison S, Lally P, Cady E, Jones R, Norman W, Scott R, Robertson NJ, Wade A, Chitty L, Taylor AM, Sebire NJ, Group MRIAS (MaRIAS) C (2015) Diagnostic accuracy and limitations of post-mortem MRI for neurological abnormalities in fetuses and children. Clin Radiol 70:872–880. https://doi.org/10.1016/j.crad.2015.04.008 CrossRefGoogle Scholar
- 7.Gilbert-Barness E, Spicer DE, Steffensen TS (2014) Handbook of pediatric autopsy pathology. SpringerGoogle Scholar
- 8.Connolly AJ, Finkbeiner WE, Ursell PC, Richard L, Davis M (2016) Autopsy pathology: a manual and atlas. ElsevierGoogle Scholar
- 10.Thayyil S, Sebire NJ, Chitty LS, Wade A, Chong W, Olsen O, Gunny RS, Offiah AC, Owens CM, Saunders DE, Scott RJ, Jones R, Norman W, Addison S, Bainbridge A, Cady EB, De VE, Robertson NJ, Taylor AM (2013) Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study. Lancet 382:223–233. https://doi.org/10.1016/S0140-6736(13)60134-8 CrossRefGoogle Scholar
- 11.Hutchinson JC, Arthurs OJ, Ashworth MT, Ramsey AT, Mifsud W, Lombardi CM, Sebire NJ (2016) Clinical utility of postmortem microcomputed tomography of the fetal heart: diagnostic imaging vs macroscopic dissection. Ultrasound Obstet Gynecol 47:58–64. https://doi.org/10.1002/uog.15764 CrossRefGoogle Scholar
- 13.Thayyil S, Cleary JO, Sebire NJ, Scott RJ, Chong K, Gunny R, Owens CM, Olsen OE, Offiah AC, Parks HG, Chitty LS, Price AN, Yousry TA, Robertson NJ, Lythgoe MF, Taylor AM (2009) Post-mortem examination of human fetuses: a comparison of whole-body high-field MRI at 9.4 T with conventional MRI and invasive autopsy. Lancet (London, England) 374:467–475. https://doi.org/10.1016/S0140-6736(09)60913-2 CrossRefGoogle Scholar
- 14.Scola E, Conte G, Palumbo G, Avignone S, Cinnante CM, Boito S, Persico N, Rizzuti T, Triulzi F (2018) High resolution post-mortem MRI of non-fixed in situ foetal brain in the second trimester of gestation: Normal foetal brain development. Eur Radiol 28:363–371. https://doi.org/10.1007/s00330-017-4965-y CrossRefGoogle Scholar
- 15.Kang X, Cannie MM, Arthurs OJ, Segers V, Fourneau C, Bevilacqua E, Cos Sanchez T, Sebire NJ, Jani JC (2017) Post-mortem whole-body magnetic resonance imaging of human fetuses: a comparison of 3-T vs. 1.5-T MR imaging with classical autopsy. Eur Radiol 27:3542–3553. https://doi.org/10.1007/s00330-016-4725-4 CrossRefGoogle Scholar
- 18.Hutchinson JC, Kang X, Shelmerdine SC, Segers V, Lombardi CM, Cannie MM, Sebire NJ, Jani JC, Arthurs OJ (2018) Postmortem microfocus computed tomography for early gestation fetuses: a validation study against conventional autopsy. Am J Obstet Gynecol 218:445.e1–445.e12. https://doi.org/10.1016/j.ajog.2018.01.040 CrossRefGoogle Scholar
- 22.Gignac PM, Kley NJ, Clarke JA, Colbert MW, Morhardt AC, Cerio D, Cost IN, Cox PG, Daza JD, Early CM, Echols MS, Henkelman RM, Herdina AN, Holliday CM, Li Z, Mahlow K, Merchant S, Müller J, Orsbon CP, Paluh DJ, Thies ML, Tsai HP, Witmer LM (2016) Diffusible iodine-based contrast-enhanced computed tomography (diceCT): an emerging tool for rapid, high-resolution, 3-D imaging of metazoan soft tissues. J Anat 228:889–909. https://doi.org/10.1111/joa.12449 CrossRefGoogle Scholar
- 24.Li Z, Clarke JA, Ketcham RA, Colbert MW, Yan F (2015) An investigation of the efficacy and mechanism of contrast-enhanced X-ray computed tomography utilizing iodine for large specimens through experimental and simulation approaches. BMC Physiol 15(5). https://doi.org/10.1186/s12899-015-0019-3