Quantification of Maceration Changes using Post Mortem MRI in Fetuses
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Published version
Accepted version
Author(s)
Type
Journal Article
Abstract
Background
Post mortem imaging is playing an increasingly important role in perinatal autopsy, and
correct interpretation of imaging changes is paramount. This is particularly important
following intra-uterine fetal death, where there may be fetal maceration. The aim of this
study was to investigate whether any changes seen on a whole body fetal post mortem
magnetic resonance imaging (PMMR) correspond to maceration at conventional
autopsy.
Methods: We performed pre-autopsy PMMR in 75 fetuses using a 1.5 Tesla Siemens
Avanto MR scanner (Erlangen, Germany). PMMR images were reported blinded to the
clinical history and autopsy data using a numerical severity scale (0 = no maceration
changes to 2 = severe maceration changes) for 6 different visceral organs (total 12).
The degree of maceration at autopsy was categorized according to severity on a
numerical scale (1 = no maceration to 4 = severe maceration). We also generated
quantitative maps to measure the liver and lung T2.
Results: The mean PMMR maceration score correlated well with the autopsy
maceration score (R2=0.93). A PMMR score of ≥ 4.5 had a sensitivity of 91%,
specificity of 64%, for detecting moderate or severe maceration at autopsy. Liver and
lung T2 were increased in fetuses with maceration scores of 3-4 in comparison to
those with 1-2 (liver p=0.03, lung p=0.02).
Conclusions: There was a good correlation between PMMR maceration score and the
extent of maceration seen at conventional autopsy. This score may be useful in
interpretation of fetal PMMR.
Post mortem imaging is playing an increasingly important role in perinatal autopsy, and
correct interpretation of imaging changes is paramount. This is particularly important
following intra-uterine fetal death, where there may be fetal maceration. The aim of this
study was to investigate whether any changes seen on a whole body fetal post mortem
magnetic resonance imaging (PMMR) correspond to maceration at conventional
autopsy.
Methods: We performed pre-autopsy PMMR in 75 fetuses using a 1.5 Tesla Siemens
Avanto MR scanner (Erlangen, Germany). PMMR images were reported blinded to the
clinical history and autopsy data using a numerical severity scale (0 = no maceration
changes to 2 = severe maceration changes) for 6 different visceral organs (total 12).
The degree of maceration at autopsy was categorized according to severity on a
numerical scale (1 = no maceration to 4 = severe maceration). We also generated
quantitative maps to measure the liver and lung T2.
Results: The mean PMMR maceration score correlated well with the autopsy
maceration score (R2=0.93). A PMMR score of ≥ 4.5 had a sensitivity of 91%,
specificity of 64%, for detecting moderate or severe maceration at autopsy. Liver and
lung T2 were increased in fetuses with maceration scores of 3-4 in comparison to
those with 1-2 (liver p=0.03, lung p=0.02).
Conclusions: There was a good correlation between PMMR maceration score and the
extent of maceration seen at conventional autopsy. This score may be useful in
interpretation of fetal PMMR.
Date Issued
2016-04-27
Date Acceptance
2016-04-21
Citation
BMC MEDICAL IMAGING, 2016, 16
ISSN
1471-2342
Publisher
BioMed Central
Journal / Book Title
BMC MEDICAL IMAGING
Volume
16
Copyright Statement
© 2016 Montaldo et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
License URL
Subjects
Nuclear Medicine & Medical Imaging
1103 Clinical Sciences
Publication Status
Published
Article Number
34