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

European Radiology volume 27, pages 3542–3553 (2017)Cite this article

Abstract

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.

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Author information

Affiliations

  1. Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium

    Xin Kang, Elisa Bevilacqua, Teresa Cos Sanchez & Jacques C. Jani

  2. Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    Mieke M. Cannie

  3. Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium

    Mieke M. Cannie

  4. Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK

    Owen J. Arthurs & Neil J. Sebire

  5. UCL Institute of Child Health, London, UK

    Owen J. Arthurs & Neil J. Sebire

  6. Department of Fetopathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium

    Valerie Segers & Catherine Fourneau

Authors
  1. Xin Kang
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  2. Mieke M. Cannie
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  3. Owen J. Arthurs
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  4. Valerie Segers
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  5. Catherine Fourneau
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  6. Elisa Bevilacqua
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  7. Teresa Cos Sanchez
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  8. Neil J. Sebire
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  9. Jacques C. Jani
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Corresponding author

Correspondence to Jacques C. Jani.

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Guarantor

The scientific guarantors of this publication are Xin Kang and Jacques Jani.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by the Fetal Medicine Foundation Belgium.

Statistics and biometry

One of the authors has significant statistical expertise.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

prospective, observational, performed at one institution.

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Cite this article

Kang, X., Cannie, M.M., Arthurs, O.J. et al. Post-mortem whole-body magnetic resonance imaging of human fetuses: a comparison of 3-T vs. 1.5-T MR imaging with classical autopsy. Eur Radiol 27, 3542–3553 (2017). https://doi.org/10.1007/s00330-016-4725-4

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  • DOI: https://doi.org/10.1007/s00330-016-4725-4

Keywords

  • Post-mortem MRI
  • 3-Tesla
  • Accuracy
  • Classical post-mortem
  • Virtual autopsy