Diagnostic accuracy of post-mortem MRI for thoracic abnormalities in fetuses and children
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objectives To compare the diagnostic accuracy of postmortem
magnetic resonance imaging (PMMR) specifically
for non-cardiac thoracic pathology in fetuses and children,
compared with conventional autopsy.
Methods Institutional ethics approval and parental consent
was obtained. A total of 400 unselected fetuses and children
underwent PMMR before conventional autopsy, reported
blinded to the other dataset.
Results Of 400 non-cardiac thoracic abnormalities, 113
(28 %) were found at autopsy. Overall sensitivity and specificity
(95 % confidence interval) of PMMR for any thoracic
pathology was poor at 39.6 % (31.0, 48.9) and 85.5 % (80.7,
89.2) respectively, with positive predictive value (PPV)
53.7 % (42.9, 64.0) and negative predictive value (NPV)
77.0 % (71.8, 81.4). Overall agreement was 71.8 % (67.1,
76.2). PMMR was most sensitive at detecting anatomical
abnormalities, including pleural effusions and lung or thoracic
hypoplasia, but particularly poor at detecting infection.
Conclusions PMMR currently has relatively poor diagnostic
detection rates for the commonest intra-thoracic pathologies
identified at autopsy in fetuses and children, including respiratory
tract infection and diffuse alveolar haemorrhage. The
reasonable NPV suggests that normal thoracic appearances
at PMMR exclude the majority of important thoracic
lesions at autopsy, and so could be useful in the context
of minimally invasive autopsy for detecting non-cardiac
thoracic abnormalities.
magnetic resonance imaging (PMMR) specifically
for non-cardiac thoracic pathology in fetuses and children,
compared with conventional autopsy.
Methods Institutional ethics approval and parental consent
was obtained. A total of 400 unselected fetuses and children
underwent PMMR before conventional autopsy, reported
blinded to the other dataset.
Results Of 400 non-cardiac thoracic abnormalities, 113
(28 %) were found at autopsy. Overall sensitivity and specificity
(95 % confidence interval) of PMMR for any thoracic
pathology was poor at 39.6 % (31.0, 48.9) and 85.5 % (80.7,
89.2) respectively, with positive predictive value (PPV)
53.7 % (42.9, 64.0) and negative predictive value (NPV)
77.0 % (71.8, 81.4). Overall agreement was 71.8 % (67.1,
76.2). PMMR was most sensitive at detecting anatomical
abnormalities, including pleural effusions and lung or thoracic
hypoplasia, but particularly poor at detecting infection.
Conclusions PMMR currently has relatively poor diagnostic
detection rates for the commonest intra-thoracic pathologies
identified at autopsy in fetuses and children, including respiratory
tract infection and diffuse alveolar haemorrhage. The
reasonable NPV suggests that normal thoracic appearances
at PMMR exclude the majority of important thoracic
lesions at autopsy, and so could be useful in the context
of minimally invasive autopsy for detecting non-cardiac
thoracic abnormalities.
Date Issued
2014-11-01
Date Acceptance
2014-07-03
Citation
European Radiology, 2014, 24 (11), pp.2876-2884
ISSN
1432-1084
Publisher
Springer Verlag (Germany)
Start Page
2876
End Page
2884
Journal / Book Title
European Radiology
Volume
24
Issue
11
Copyright Statement
© The Author(s) 2014. This article is published with open access at Springerlink.com
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Radiology, Nuclear Medicine & Medical Imaging
MRI
Autopsy
Pathology
Fetuses
Children
CONVENTIONAL AUTOPSY
UNEXPECTED DEATH
EXPERIENCE
Publication Status
Published