Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
UCL Great Ormond Street Institute of Child Health, London, UK.
Prenat Diagn. 2017 Jun;37(6):566-574. doi: 10.1002/pd.5043. Epub 2017 May 23.
The objective of the study is to compare diagnostic accuracy of perinatal post-mortem magnetic resonance (PMMR) imaging against conventional autopsy, when reported by a single-blinded observer for all organ systems following a period of initial experience.
We compared pre-autopsy PMMR with conventional autopsy for the detection of (1) major pathological abnormalities related to the cause of death and (2) all diagnostic findings in five different body organ systems. PMMR was reported blinded to autopsy findings.
In 201 cases, 123/146 (84.2%) of major abnormalities were identified by PMMR. Overall diagnostic accuracy of PMMR was 89.6% [95% confidence interval (CI): 84.3, 93.2%] across all cases, with high concordance 91.8% (95% CI: 89.9, 93.4%) across most organ systems. Our study showed higher concordance than single reporter statistics previously reported in neurological [92.2% vs 73.8%; diff 18.4% (95% CI: 11.0, 25.4%) p < 0.01] and thoracic systems [93.7% vs 81.2%; diff 12.5% (95% CI: 6.3, 18.4%) p < 0.01] and slightly better overall [91.8% vs 87.1%; diff 4.7% (95% CI: 2.1, 7.3%) p < 0.01].
The PMMR examinations can be reliably reported by a single radiologist, following a period of experience and training with this specific modality, with high-diagnostic accuracy for all organ systems. © 2017 John Wiley & Sons, Ltd.
本研究旨在比较围产期磁共振成像(PMMR)与传统尸检在单一盲法观察者报告所有器官系统时的诊断准确性,且该观察者在经历一段初始经验期后进行报告。
我们比较了 PMMR 与传统尸检在以下五个不同身体器官系统中的(1)与死亡原因相关的主要病理异常,以及(2)所有诊断发现的检测情况。PMMR 的报告是盲于尸检结果的。
在 201 例中,123/146(84.2%)例主要异常通过 PMMR 识别。PMMR 的整体诊断准确性为 89.6%[95%置信区间(CI):84.3,93.2%],在所有病例中,高一致性为 91.8%(95%CI:89.9,93.4%),在大多数器官系统中。我们的研究显示出比之前在神经[92.2%比 73.8%;差异 18.4%(95%CI:11.0,25.4%)p<0.01]和胸系统[93.7%比 81.2%;差异 12.5%(95%CI:6.3,18.4%)p<0.01]中单个报告者统计学更高的一致性,且整体略高[91.8%比 87.1%;差异 4.7%(95%CI:2.1,7.3%)p<0.01]。
在经历了一段时间的经验和特定模态的培训后,PMMR 检查可由单一放射科医生可靠地报告,具有所有器官系统的高诊断准确性。©2017 年约翰威立父子公司。