Learning effect on perinatal post-mortem magnetic resonance imaging reporting: single reporter diagnostic accuracy of 200 cases.
OBJECTIVE
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.


METHODS
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.


RESULTS
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].


CONCLUSIONS
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.
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Clare
C
Ashwin
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|UCL Great Ormond Street Institute of Child Health, London, UK.
J Ciaran
JC
Hutchinson
Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
Xin
X
Kang
UCL Great Ormond Street Institute of Child Health, London, UK.
Dean
D
Langan
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK.
Rod
R
Jones
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK.
Wendy
W
Norman
Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.|Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Mieke
M
Cannie
Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium.
Jacques
J
Jani
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|UCL Great Ormond Street Institute of Child Health, London, UK.
Neil J
NJ
Sebire
Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|UCL Great Ormond Street Institute of Child Health, London, UK.
Owen J
http://orcid.org/0000-0003-1213-3516
OJ
Arthurs
D001344:Autopsy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D059032:Learning Curve; D008279:Magnetic Resonance Imaging; D066087:Perinatal Death