title: Diagnostic accuracy of post mortem MRI for abdominal abnormalities in foetuses and children.
abstract: BACKGROUND
  To compare the diagnostic accuracy of post-mortem magnetic resonance imaging (PMMR) specifically for abdominal pathology in foetuses and children, compared to conventional autopsy.
  
  
  METHODS
  Institutional ethics approval and parental consent was obtained. 400 unselected foetuses and children underwent PMMR using a 1.5T Siemens Avanto MR scanner before conventional autopsy. PMMR images and autopsy findings were reported blinded to the other data respectively.
  
  
  RESULTS
  Abdominal abnormalities were found in 70/400 (12%) autopsies. Overall sensitivity and specificity (95% confidence interval) of PMMR for abdominal pathology was 72.5% (61.0, 81.6) and 90.8% (87.0, 93.6), with positive (PPV) and negative predictive values (NPV) of 64.1% (53.0, 73.9) and 93.6% (90.2, 95.8) respectively. PMMR was good at detecting renal abnormalities (sensitivity 80%), particularly in foetuses, and relatively poor at detecting intestinal abnormalities (sensitivity 50%). Overall accuracy was 87.4% (83.6, 90.4).
  
  
  CONCLUSIONS
  PMMR has high overall accuracy for abdominal pathology in foetuses, newborns and children. PMMR is particularly good at detecting renal abnormalities, and relatively poor at detecting intestinal abnormalities. In clinical practice, PMMR may be a useful alternative or adjunct to conventional autopsy in foetuses and children for detecting abdominal abnormalities.
authors.affiliation: Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Institute of Child Health, UCL, London, UK. Electronic address: owen.arthurs@gosh.nhs.uk.
authors.forename: Owen J
authors.initials: OJ
authors.lastname: Arthurs
authors.affiliation: Perinatal Neurology and Neonatology, Imperial College London, London, UK. Electronic address: s.thayyil@imperial.ac.uk.
authors.forename: Sudhin
authors.initials: S
authors.lastname: Thayyil
authors.affiliation: Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: Catherine.owens@gosh.nhs.uk.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Owens
authors.affiliation: Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Institute of Child Health, UCL, London, UK. Electronic address: oystein.olsen@gosh.nhs.uk.
authors.forename: Oystein E
authors.initials: OE
authors.lastname: Olsen
authors.affiliation: Clinical Epidemiology, Nutrition and Biostatistics Section, UCL Institute of Child health, London, UK. Electronic address: a.wade@ucl.ac.uk.
authors.forename: Angie
authors.initials: A
authors.lastname: Wade
authors.affiliation: Perinatal Neurology and Neonatology, Imperial College London, London, UK. Electronic address: shea.addison@imperial.ac.uk.
authors.forename: Shea
authors.initials: S
authors.lastname: Addison
authors.affiliation: Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: rod.jones@gosh.nhs.uk.
authors.forename: Rod
authors.initials: R
authors.lastname: Jones
authors.affiliation: Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: wendy.norman@gosh.nhs.uk.
authors.forename: Wendy
authors.initials: W
authors.lastname: Norman
authors.affiliation: Department of Histopathology, University College London Hospital NHS Trust, London, UK. Electronic address: rosemary.scott@uclh.nhs.uk.
authors.forename: Rosemary J
authors.initials: RJ
authors.lastname: Scott
authors.affiliation: Academic Neonatology, UCL Institute for Women's Health, London, UK. Electronic address: n.robertson@ucl.ac.uk.
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Robertson
authors.affiliation: Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK; Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: a.taylor76@ucl.ac.uk.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Taylor
authors.affiliation: Genetics and Genomic Medicine, UCL Institute of Child Health, London, Great Ormond Street Hospital for Children NHS Foundation Trust, London, and UCLH NHS Foundation Trusts, London, UK. Electronic address: l.chitty@ucl.ac.uk.
authors.forename: Lyn S
authors.initials: LS
authors.lastname: Chitty
authors.affiliation: Department of Histopathology, UCL Institute of Child Health & Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Electronic address: neil.sebire@gosh.nhs.uk.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Sebire
mesh_terms: D000005:Abdomen / Q000473:pathology*; D001344:Autopsy / Q000379:methods; D002648:Child; D005260:Female; D005333:Fetus / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013158:Splenic Diseases / Q000473:pathology*
keywords: Accuracy; Autopsy; Children; Foetuses; MRI; Pathology