Alderliesten Marianne E, Peringa Jan, van der Hulst Victor P M, Blaauwgeers Hans L G, van Lith Jan M M
Department of Obstetrics and Gynecology, OLVG Hospital, Amsterdam, The Netherlands.
BJOG. 2003 Apr;110(4):378-82.
To compare postmortem magnetic resonance imaging (MRI) with autopsy in perinatal deaths. To determine the acceptance and feasibility of postmortem perinatal MRI.
Cohort study.
Large teaching hospital.
Fetuses and neonates from 16 weeks gestational age until 28 days after birth, stillbirths as well as intrapartum and neonatal deaths.
MRI was performed prior to autopsy in a consecutive cohort of perinatal deaths after full parental consent. Agreement between MRI and autopsy was calculated. The consent rate for both examinations was recorded separately, as well as the time between the perinatal death and the MRI.
Full agreement between MRI and autopsy.
Of 58 cases, 26 parents consented to both examinations (45%). Autopsy showed 18 major malformations, of which 10 were detected with MRI. The positive predictive value of MRI was 80% (4/5) and the negative predictive value was 65% (13/20). Additional consent for MRI was given in eight cases (14%). In 84%, the MRI could be performed within 48 hours.
MRI is of value if autopsy is refused, but diagnostic accuracy is insufficient to recommend substitution of full autopsy. The acceptance rate of MRI only is better than that of autopsy.
比较围产期死亡病例的尸检磁共振成像（MRI）与尸检结果。确定围产期尸检MRI的可接受性和可行性。
队列研究。
大型教学医院。
孕龄16周直至出生后28天的胎儿和新生儿，包括死产以及分娩期和新生儿死亡病例。
在获得父母完全同意后，对连续的围产期死亡病例队列在尸检前进行MRI检查。计算MRI与尸检结果的一致性。分别记录两项检查的同意率，以及围产期死亡与MRI检查之间的时间间隔。
MRI与尸检结果完全一致。
58例病例中，26位家长同意两项检查（45%）。尸检发现18例主要畸形，其中10例通过MRI检测到。MRI的阳性预测值为80%（4/5），阴性预测值为65%（13/20）。另外8例（14%）给予了MRI检查的额外同意。84%的情况下，MRI可在48小时内完成。
如果拒绝尸检，MRI有一定价值，但诊断准确性不足以推荐替代全面尸检。仅MRI的接受率高于尸检。
