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01-07-2016 | Paediatric

Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI

Authors: Owen J. Arthurs, Anna Guy, Sudhin Thayyil, Angie Wade, Rod Jones, Wendy Norman, Rosemary Scott, Nicola J. Robertson, Thomas S. Jacques, W. K. ‘Kling’ Chong, Roxanna Gunny, Dawn Saunders, Oystein E. Olsen, Catherine M. Owens, Amaka C. Offiah, Lyn S. Chitty, Andrew M. Taylor, Neil J. Sebire, for the Magnetic Resonance Imaging Autopsy Study (MaRIAS) Collaborative Group

Published in: European Radiology | Issue 7/2016

Abstract

Objectives

To compare the diagnostic yield of whole-body post-mortem computed tomography (PMCT) imaging to post-mortem magnetic resonance (PMMR) imaging in a prospective study of fetuses and children.

Methods

We compared PMCT and PMMR to conventional autopsy as the gold standard for the detection of (a) major pathological abnormalities related to the cause of death and (b) all diagnostic findings in five different body organ systems.

Results

Eighty two cases (53 fetuses and 29 children) underwent PMCT and PMMR prior to autopsy, at which 55 major abnormalities were identified. Significantly more PMCT than PMMR examinations were non-diagnostic (18/82 vs. 4/82; 21.9 % vs. 4.9 %, diff 17.1 % (95 % CI 6.7, 27.6; p < 0.05)). PMMR gave an accurate diagnosis in 24/55 (43.64 %; 95 % CI 31.37, 56.73 %) compared to 18/55 PMCT (32.73 %; 95 % CI 21.81, 45.90). PMCT was particularly poor in fetuses <24 weeks, with 28.6 % (8.1, 46.4 %) more non-diagnostic scans. Where both PMCT and PMMR were diagnostic, PMMR gave slightly higher diagnostic accuracy than PMCT (62.8 % vs. 59.4 %).

Conclusion

Unenhanced PMCT has limited value in detection of major pathology primarily because of poor-quality, non-diagnostic fetal images. On this basis, PMMR should be the modality of choice for non-invasive PM imaging in fetuses and children.

Key Points

• Overall 17.1 % more PMCT examinations than PMMR were non-diagnostic

• 28.6 % more PMCT were non-diagnostic than PMMR in fetuses <24 weeks

• PMMR detected almost a third more pathological abnormalities than PMCT

• PMMR gave slightly higher diagnostic accuracy when both were diagnostic

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Title: Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI
Authors: Owen J. Arthurs
Anna Guy
Sudhin Thayyil
Angie Wade
Rod Jones
Wendy Norman
Rosemary Scott
Nicola J. Robertson
Thomas S. Jacques
W. K. ‘Kling’ Chong
Roxanna Gunny
Dawn Saunders
Oystein E. Olsen
Catherine M. Owens
Amaka C. Offiah
Lyn S. Chitty
Andrew M. Taylor
Neil J. Sebire
for the Magnetic Resonance Imaging Autopsy Study (MaRIAS) Collaborative Group
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4057-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of diagnostic performance for perinatal and paediatric post-mortem imaging: CT versus MRI

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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