Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature

Eur J Pediatr. 2018 Jun;177(6):791-803. doi: 10.1007/s00431-018-3135-9. Epub 2018 Apr 19.


Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice.

Conclusion: Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post-mortem magnetic resonance imaging can be complementary thereof.

Keywords: Autopsy; Foetal; Neonatal; Paediatric; Post-mortem; Radiology.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adolescent
  • Autopsy / methods*
  • Cause of Death*
  • Child
  • Child, Preschool
  • Fetal Death / etiology
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging*
  • Netherlands
  • Radiography
  • Tomography, X-Ray Computed*
  • Ultrasonography*