Postmortem fetal imaging: prospective blinded comparison of two-dimensional ultrasound with magnetic resonance imaging.
Abdomen
/ diagnostic imaging
Abortion, Induced
/ statistics & numerical data
Autopsy
/ methods
Belgium
/ epidemiology
Brain
/ diagnostic imaging
Cause of Death
Female
Fetal Death
/ etiology
Fetus
/ diagnostic imaging
Gestational Age
Heart
/ diagnostic imaging
Humans
Magnetic Resonance Imaging
/ methods
Pregnancy
Prospective Studies
Sensitivity and Specificity
Spine
/ diagnostic imaging
Thorax
/ diagnostic imaging
Ultrasonography
/ methods
MRI
autopsy
postmortem
termination
ultrasound
Journal
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
20
10
2018
revised:
07
12
2018
accepted:
10
01
2019
pubmed:
16
1
2019
medline:
6
5
2020
entrez:
16
1
2019
Statut:
ppublish
Résumé
To compare the diagnostic rate and accuracy of 3-Tesla (T) postmortem magnetic resonance imaging (PM-MRI) and postmortem ultrasound (PM-US) in an unselected fetal population. We performed prospectively, in a blinded manner, 3-T PM-MRI and PM-US on 160 unselected fetuses at 13-41 weeks of gestation. All imaging was reported according to a prespecified template, for five anatomical regions: brain, thorax, heart, abdomen and spine. The rates of non-diagnostic results for PM-US and PM-MRI were compared and, for results that were diagnostic, we calculated sensitivity, specificity and concordance rates for each anatomical region, using conventional autopsy as the reference standard. 3-T PM-MRI performed significantly better than did PM-US overall and in particular for fetuses ≥ 20 weeks' gestation. Specifically, the non-diagnostic rates for PM-MRI vs PM-US were 4.4% vs 26.9% (7/160 vs 43/160; P < 0.001) for the brain, 5.2% vs 17.4% (8/155 vs 27/155; P < 0.001) for the thorax, 3.8% vs 30.6% (6/157 vs 48/157; P < 0.001) for the heart and 3.2% vs 23.6% (5/157 vs 37/157; P < 0.001) for the abdomen. For the spine, both techniques showed an equally low non-diagnostic rate. When both postmortem imaging techniques were diagnostic, they had similar accuracy, with no difference in sensitivity or specificity, and similar concordance with autopsy (PM-US, 79.5-96.5%; PM-MRI, 81.6-99.1%). PM-MRI performed significantly better than PM-US in this unselected population, due mainly to a lower non-diagnostic rate. PM-MRI should remain the first-line imaging investigation for perinatal autopsy, but PM-US could be considered if MRI is not available, albeit with a higher non-diagnostic rate. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
791-799Subventions
Organisme : The Fetal Medicine Foundation Belgium
ID : NANIHR Senior Investigator awardNIHR-CDF-2017-10-037National Institute for Health Research (NIHR) Care
Organisme : Department of Health
ID : CDF-2017-10-037
Pays : United Kingdom
Organisme : Great Ormond Street Children’s Charity and Great Ormond Street Hospital NIHR Biomedical Research Centre
ID : NA
Organisme : Department of Health
ID : HTA/14/168/02
Pays : United Kingdom
Organisme : NIHR Senior Investigator award
ID : NA
Organisme : National Institute for Health Research (NIHR) Career Development Fellowship
ID : NIHR-CDF-2017-10-037
Informations de copyright
Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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