title: Diagnostic accuracy of post-mortem magnetic resonance imaging in fetuses, children and adults: a systematic review.
abstract: 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.
authors.affiliation: Centre for Cardiovascular Imaging, UCL Institute of Child Health, London, UK. s.thayyil@ucl.ac.uk
authors.forename: Sudhin
authors.initials: S
authors.lastname: Thayyil
authors.forename: Manigandan
authors.initials: M
authors.lastname: Chandrasekaran
authors.forename: Lyn S
authors.initials: LS
authors.lastname: Chitty
authors.forename: Angie
authors.initials: A
authors.lastname: Wade
authors.forename: Jolene
authors.initials: J
authors.lastname: Skordis-Worrall
authors.forename: Ian
authors.initials: I
authors.lastname: Bennett-Britton
authors.forename: Marta
authors.initials: M
authors.lastname: Cohen
authors.forename: Elspeth
authors.initials: E
authors.lastname: Withby
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Sebire
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Robertson
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Taylor
mesh_terms: 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