Diagnostic accuracy of post-mortem MRI for thoracic abnormalities in fetuses and children

Magnetic Resonance Imaging Autopsy Study (MaRIAS) Collaborative Group

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: To compare the diagnostic accuracy of post-mortem 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.

KEY POINTS: • PMMR has relatively poor diagnostic detection rates for common intrathoracic pathology • The moderate NPV suggests that normal PMMR appearances exclude most important abnormalities • Lung sampling at autopsy remains the "gold standard" for pulmonary pathology.

Original languageEnglish
Pages (from-to)2876-84
Number of pages9
JournalEuropean Radiology
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 2014

Keywords / Materials (for Non-textual outputs)

  • Adolescent
  • Autopsy
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Fetal Diseases/diagnosis
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging/methods
  • Male
  • Pregnancy
  • ROC Curve
  • Reproducibility of Results
  • Thoracic Diseases/congenital

Fingerprint

Dive into the research topics of 'Diagnostic accuracy of post-mortem MRI for thoracic abnormalities in fetuses and children'. Together they form a unique fingerprint.

Cite this