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Postmortem fetal imaging: a prospective blinded comparison study of 2-dimensional ultrasound with MR imaging

Kang, X; Cos Sanchez, T; Arthurs, OJ; Bevilacqua, E; Cannie, MM; Segers, V; Lecomte, S; ... Jani, JC; + view all (2019) Postmortem fetal imaging: a prospective blinded comparison study of 2-dimensional ultrasound with MR imaging. Ultrasound in Obstetrics and Gynaecology 10.1002/uog.20217. (In press).

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Abstract

OBJECTIVE: To compare the diagnostic rate and diagnostic accuracy of 3 Tesla (T) postmortem magnetic resonance imaging (PMMRI) and postmortem ultrasound (PMUS) in an unselected population. METHODS: In a blinded manner, we prospectively performed 3T PMMRI and PMUS on 160 unselected fetuses at 13-41 weeks of gestation. All imaging was reported according to a pre-specified template, for 5 anatomical regions: brain, thorax, heart, abdomen and spine. McNemar test for paired proportion was used to compare the non-diagnostic results rates of PMUS and PMMRI. When diagnostic, sensitivity, specificity and concordance rates for each anatomical region were calculated, using conventional autopsy as the reference standard. RESULTS: 3T PMMR performed significantly better than PMUS overall. Specifically, for the brain (7 non-diagnostic vs 43/160; 4.4% vs 26.9%; p<0.001), thorax (8 non-diagnostic vs 27/155; 5.2% vs 17.4%; p<0.001), heart (6 non-diagnostic vs 48/157; 3.8% vs 30.6%; p<0.001) and abdomen (5 non-diagnostic vs 37/157; 3.2% vs 23.6%; p<0.001). However, when diagnostic, we found similar accuracy for PMUS and PMMRI, with no difference in sensitivity or specificity, and similar concordance (PMUS 81.8-96.5%; PMMRI 81.6-99.1%). CONCLUSION: PMMRI performed significantly better than PMUS in this population, mainly due to a lower non-diagnostic study rate. PMMRI remains the first line imaging investigation for perinatal autopsy, but PMUS could be considered where MRI is not available, accepting a higher non-diagnostic rate. This article is protected by copyright. All rights reserved.

Type: Article
Title: Postmortem fetal imaging: a prospective blinded comparison study of 2-dimensional ultrasound with MR imaging
Location: England
DOI: 10.1002/uog.20217
Publisher version: http://doi.org/10.1002/uog.20217
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: MRI, autopsy, postmortem, termination, ultrasound
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Developmental Neurosciences Prog
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > UCL GOS Institute of Child Health > ICH Pop, Policy and Practice Prog
URI: http://discovery.ucl.ac.uk/id/eprint/10067069
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