Kang Xin, Cannie Mieke M, Arthurs Owen J, Segers Valerie, Fourneau Catherine, Bevilacqua Elisa, Cos Sanchez Teresa, Sebire Neil J, Jani Jacques C
Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium.
Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
Eur Radiol. 2017 Aug;27(8):3542-3553. doi: 10.1007/s00330-016-4725-4. Epub 2017 Jan 23.
To prospectively compare diagnostic accuracy of fetal post-mortem whole-body MRI at 3-T vs. 1.5-T.
Between 2012 and 2015, post-mortem MRI at 1.5-T and 3-T was performed in fetuses after miscarriage/stillbirth or termination. Clinical MRI diagnoses were assessed using a confidence diagnostic score and compared with classical autopsy to derive a diagnostic error score. The relation of diagnostic error for each organ group with gestational age was calculated and 1.5-T with 3-T was compared with accuracy analysis.
135 fetuses at 12-41 weeks underwent post-mortem MRI (followed by conventional autopsy in 92 fetuses). For all organ groups except the brain, and for both modalities, the diagnostic error decreased with gestation (P < 0.0001). 3-T MRI diagnostic error was significantly lower than that of 1.5-T for all anatomic structures and organ groups, except the orbits and brain. This difference was maintained for fetuses <20 weeks gestation. Moreover, 3-T was associated with fewer non-diagnostic scans and greater concordance with classical autopsy than 1.5-T MRI, especially for the thorax, heart and abdomen in fetuses <20 weeks.
Post-mortem fetal 3-T MRI improves confidence scores and overall accuracy compared with 1.5-T, mainly for the thorax, heart and abdomen of fetuses <20 weeks of gestation.
• In PM-MRI, diagnostic error using 3-T is lower than that with 1.5-T. • In PM-MRI, diagnostic scan rate is higher using 3-T than 1.5-T. • In PM-MRI, concordance with classical autopsy increases with 3-T. • PM-MRI using 3-T is particularly interesting for thoracic and abdominal organs. • PM-MRI using 3-T is particularly interesting for fetuses < 20 weeks' gestation.
前瞻性比较3-T与1.5-T胎儿尸检全身MRI的诊断准确性。
2012年至2015年期间，对流产/死产或引产胎儿进行了1.5-T和3-T的尸检MRI检查。使用置信诊断评分评估临床MRI诊断，并与传统尸检进行比较以得出诊断误差评分。计算每个器官组的诊断误差与胎龄的关系，并将1.5-T与3-T进行准确性分析比较。
135例孕12-41周的胎儿接受了尸检MRI检查（其中92例随后进行了传统尸检）。对于除脑以外的所有器官组，以及两种检查方式，诊断误差均随孕周增加而降低（P < 0.0001）。除眼眶和脑外，3-T MRI对所有解剖结构和器官组的诊断误差均显著低于1.5-T。对于孕周<20周的胎儿，这种差异依然存在。此外，与1.5-T MRI相比，3-T检查未诊断出的扫描更少，与传统尸检的一致性更高，尤其是对于孕周<20周胎儿的胸部、心脏和腹部。
与1.5-T相比，3-T胎儿尸检MRI提高了置信评分和总体准确性，主要体现在孕周<20周胎儿的胸部、心脏和腹部。
• 在胎儿尸检MRI中，3-T的诊断误差低于1.5-T。• 在胎儿尸检MRI中，3-T的诊断扫描率高于1.5-T。• 在胎儿尸检MRI中，3-T与传统尸检的一致性更高。• 3-T胎儿尸检MRI对胸腹部器官特别有意义。• 3-T胎儿尸检MRI对孕周<20周的胎儿特别有意义。
