Journal Article

Post-mortem whole-body magnetic resonance imaging of human fetuses: a comparison of 3-T vs. 1.5-T MR imaging with classical autopsy

Kang, Xin, Sebire, Neil J., Cos Sanchez, Teresa, Arthurs, Owen J., Fourneau, Catherine, Segers, Valerie, Jani, Jacques C., Cannie, Mieke M., Bevilacqua, Elisa

2017

Overview

Objective To prospectively compare diagnostic accuracy of fetal post-mortem whole-body MRI at 3-T vs. 1.5-T. Methods 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. Results 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. Conclusion 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. Key Points • 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.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Abdomen / Abortion, Induced / Abortion, Spontaneous - diagnostic imaging / Abortion, Spontaneous - pathology / Accuracy / Autopsies / Autopsy / Autopsy - methods / Brain / Brain - diagnostic imaging / Brain - pathology / Condoms / Diagnostic Errors / Diagnostic Radiology / Errors / Female / Fetal Diseases - diagnostic imaging / Fetal Diseases - pathology / Fetus - diagnostic imaging / Fetus - pathology / Fetuses / Gestation / Gestational Age / Heart - diagnostic imaging / Humans / Imaging / Internal Medicine / Interventional Radiology / Magnetic Resonance / Magnetic resonance imaging / Magnetic Resonance Imaging - methods / Medical imaging / Medicine / Medicine & Public Health / Myocardium - pathology / Neuroimaging / Neuroradiology / NMR / Nuclear magnetic resonance / Organs / Pregnancy / Prospective Studies / Radiology / Stillbirth / Thorax / Thorax - diagnostic imaging / Thorax - pathology / Ultrasound / Whole Body Imaging - methods