Susan C Shelmerdine1,2, Owen J Arthurs1,2, Isobel Gilpin3, Wendy Norman4,5, Rod Jones4,5, Andrew M Taylor4,5, Neil J Sebire1,2, Lyn S Chitty1,6. 1. Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. 2. UCL Great Ormond Street Institute of Child Health, London, UK. 3. Perinatal Neurology and Neonatology, Imperial College London, London, UK. 4. Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. 5. Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK. 6. Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London, UK.
Abstract
OBJECTIVE: To determine the additional yield from autopsy following prenatal ultrasound and post-mortem magnetic resonance imaging (PMMR) for structural abnormalities. METHOD: PMMR was performed on consecutive fetuses over a 6-year period. Prenatal ultrasound and PMMR findings were categorised as concordant, partially concordant or discordant findings. The yield of new and clinically significant information from autopsy was assessed. Diagnostic accuracies for both modalities were calculated, using autopsy as reference standard. RESULTS: Our study consisted of 81 fetuses. PMMR and prenatal ultrasound findings were concordant in 44/81 (54.3%), partially concordant in 26/81 (32.1%) and discordant in 11/81 (13.6%) cases. In 19/81 cases (23%), autopsy provided additional information, which appeared clinically significant in 12 cases. In 10 of those 12 cases, there was discordance between PMMR and ultrasound. In only 2 of 44 cases where ultrasound and PMMR were concordant, did autopsy provide clinically significant information. Diagnostic accuracy rates for ultrasound were sensitivity of 76.8% (66.6%, 84.6%), specificity of 92.5% (88.9%, 95.0%). For PMMR the sensitivity was 79.0% (68.9%, 86.5%), specificity 97.9% (95.5%, 99.0%). PMMR had a significantly higher concordance rate with autopsy than ultrasound (89.0 vs 93.8%; P < .001). CONCLUSION: Where PMMR and ultrasound are concordant, there is little additional yield from autopsy.
OBJECTIVE: To determine the additional yield from autopsy following prenatal ultrasound and post-mortem magnetic resonance imaging (PMMR) for structural abnormalities. METHOD: PMMR was performed on consecutive fetuses over a 6-year period. Prenatal ultrasound and PMMR findings were categorised as concordant, partially concordant or discordant findings. The yield of new and clinically significant information from autopsy was assessed. Diagnostic accuracies for both modalities were calculated, using autopsy as reference standard. RESULTS: Our study consisted of 81 fetuses. PMMR and prenatal ultrasound findings were concordant in 44/81 (54.3%), partially concordant in 26/81 (32.1%) and discordant in 11/81 (13.6%) cases. In 19/81 cases (23%), autopsy provided additional information, which appeared clinically significant in 12 cases. In 10 of those 12 cases, there was discordance between PMMR and ultrasound. In only 2 of 44 cases where ultrasound and PMMR were concordant, did autopsy provide clinically significant information. Diagnostic accuracy rates for ultrasound were sensitivity of 76.8% (66.6%, 84.6%), specificity of 92.5% (88.9%, 95.0%). For PMMR the sensitivity was 79.0% (68.9%, 86.5%), specificity 97.9% (95.5%, 99.0%). PMMR had a significantly higher concordance rate with autopsy than ultrasound (89.0 vs 93.8%; P < .001). CONCLUSION: Where PMMR and ultrasound are concordant, there is little additional yield from autopsy.
Authors: Ian Craig Simcock; Susan Cheng Shelmerdine; Dean Langan; Guy Anna; Neil James Sebire; Owen John Arthurs Journal: BMC Med Imaging Date: 2021-08-24 Impact factor: 1.930
Authors: Susan C Shelmerdine; J Ciaran Hutchinson; Celine Lewis; Ian C Simcock; Thivya Sekar; Neil J Sebire; Owen J Arthurs Journal: Insights Imaging Date: 2021-07-15