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- Title
Postmortem fetal imaging: prospective blinded comparison of two-dimensional ultrasound with magnetic resonance imaging.
- Authors
Kang, X.; Sanchez, T. Cos; Arthurs, O. J.; Bevilacqua, E.; Cannie, M. M.; Segers, V.; Lecomte, S.; Sebire, N. J.; Jani, J. C.
- Abstract
<bold>Objective: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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%).<bold>Conclusions: </bold>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.
- Subjects
MAGNETIC resonance imaging; FETAL imaging; AUTOPSY
- Publication
Ultrasound in Obstetrics & Gynecology, 2019, Vol 54, Issue 6, p791
- ISSN
0960-7692
- Publication type
journal article
- DOI
10.1002/uog.20217