Diagnostic accuracy of post-mortem magnetic resonance imaging in fetuses, children and adults: a systematic review.
To determine, in a systematic review, the diagnostic accuracy, acceptability and cost-effectiveness of less invasive autopsy by post-mortem MR imaging, in fetuses, children and adults. We searched Medline, Embase, the Cochrane library and reference lists to identify all studies comparing post-mortem MR imaging with conventional autopsy, published between January 1990 and March 2009. 539 abstracts were identified; 15 papers met the inclusion criteria; data from 9 studies were extracted (total: 146 fetuses, 11 children and 24 adults). In accurately identifying the final cause of death or most clinically significant abnormality, post-mortem MR imaging had a sensitivity and specificity of 69% (95% CI-56%, 80%) and 95% (95% CI-88%, 98%) in fetuses, and 28% (95% CI-13%, 47%) and 64% (95% CI-23%, 94%) in children and adults, respectively; however the published data is limited to small, heterogenous and poorly designed studies. Insufficient data is available on acceptability and economic evaluation of post-mortem MR imaging. Well designed, large, prospective studies are required to evaluate the accuracy of post-mortem MR imaging, before it can be offered as a clinical tool.
Thayyil
Sudhin
S
Centre for Cardiovascular Imaging, UCL Institute of Child Health, London, UK. s.thayyil@ucl.ac.uk
Chandrasekaran
Manigandan
M
Chitty
Lyn S
LS
Wade
Angie
A
Skordis-Worrall
Jolene
J
Bennett-Britton
Ian
I
Cohen
Marta
M
Withby
Elspeth
E
Sebire
Neil J
NJ
Robertson
Nicola J
NJ
Taylor
Andrew M
AM
D000293:Adolescent; D000328:Adult; D001344:Autopsy / Q000191:economics* / Q000379:methods; D002648:Child; D005260:Female; D005315:Fetal Diseases / Q000191:economics* / Q000473:pathology*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000191:economics* / Q000706:statistics & numerical data*; D008297:Male; D011296:Prenatal Diagnosis / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data*; D055815:Young Adult