First experience with 0.31 Tesla low-field MRI in post-mortem fetal examinations.

Post-mortem imaging has become an important adjunct or alternative to autopsy in perinatal pathology and forensic medicine, particularly when conventional autopsy is limited or declined. However, high-field MRI, currently the post-mortem imaging gold standard for fetuses, is not always available in many forensic settings. The aim of this study was to evaluate whether a 0.31 Tesla low-field MRI scanner, which offers advantages in affordability, installation, infrastructural requirements such as reduced power, cooling, and shielding demands, and lower safety constraints associated with its field strength, can deliver diagnostically relevant information in post-mortem fetal examinations within a forensic context. Three fetuses underwent post-mortem low-field MRI prior to autopsy and histopathological assessment. Imaging findings were compared with autopsy results to evaluate diagnostic concordance and potential added value in a forensic context. Low-field MRI successfully identified key anatomical abnormalities: Fetus #1 showed a cerebral lesion on MRI that could not be recognized during the autopsy due to autolysis-related loss of structural integrity of the brain after opening the skullcap. Fetus #2 presented with a left-sided diaphragmatic hernia with enterothorax. Fetus #3 exhibited gastroschisis and a renal abnormality. Using the 0.31 Tesla low-field MRI scanner provided sufficient diagnostic detail to support and complement the forensic examinations of fetal deaths. It can improve the documentation and interpretation of findings in perinatal forensic cases, enhance diagnostic certainty in decomposed or fragile remains, and offer a viable alternative when parental refusal or legal constraints prevent full autopsy.