Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study

Thayyil, Sudhin; Sebire, Neil J.; Chitty, Lyn S.; Wade, Angie; Chong, W.K.; Olsen, Øystein E.; Gunny, Roxana; Offiah, A.C.; Owens, Cátherine M.; Saunders, Dawn; Scott, R. K.; Jones, Rod; Norman, Wendy; Addison, S; Bainbridge, Alan; Cady, Ernest B.; Vita, Enrico De; Robertson, Nicola J.; Taylor, Andrew M.

doi:10.1016/s0140-6736(13)60134-8

Cited by 256 publications

(279 citation statements)

References 27 publications

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“…We conclude that PMMR in isolation is not yet able to provide a reliable alternative to autopsy, and more work needs to be done if this is to be proposed as a working model in the future. 31 The data from the MaRIAS emphasized that PMMR was most accurate in detecting cerebral (Figure 2), cardiac and renal abnormalities. When MRI was used as part of an MIA, in 65% (258/400) of cases opening the head for formal brain autopsy was unnecessary.…”

Section: The Mri Autopsy Studymentioning

confidence: 96%

“…Imaging techniques are already being used clinically as part of a full post-mortem in many hospitals, but validating MRI as an alternative to conventional autopsy has only recently been investigated. 31 …”

Section: Minimally Invasive Autopsy: Adjunct or Alternative?mentioning

confidence: 99%

“…MRI findings alone, and MRI findings in conjunction with ancillary assessments (termed MIA), were compared with conventional autopsy findings, the diagnostic gold standard, for accuracy of detecting cause of death or major pathological abnormalities. For the purposes of this study, MIA is defined as post-mortem investigations with no incisions or dissections but with post-mortem blood sampling via needle 31 This gave an overall concordance rate in children of 76.4% (94/123), mainly as a result of undetected myocarditis or pneumonia, or systemic sepsis.…”

Section: The Mri Autopsy Studymentioning

confidence: 99%

“…On the other hand, in 30% (13/43) of cases (small foetuses) in which neuropathology was inconclusive as a result of autolysis, MRI was able to detect clinically important lesions. This suggests not only that PMMR of brain and spinal cord should be routinely performed in all foetuses for obtaining optimal post-mortem information 31 but also that opening the skull when PMMR was normal did not yield significant additional pathological information contributing to the cause of death…”

Section: The Mri Autopsy Studymentioning

confidence: 99%

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Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Addison¹,

Arthurs²,

Thayyil³

2014

BJR

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Although post-mortem MRI (PMMR) was proposed as an alternative to conventional autopsy more than a decade ago, the lack of systematic validation has limited its clinical uptake. Minimally invasive autopsy (MIA) using PMMR together with ancillary investigations has now been shown to be as accurate as conventional autopsy in foetuses, newborns and infants and is particularly useful for cerebral, cardiac and genitourinary imaging. Unlike conventional autopsy, PMMR provides a permanent three-dimensional auditable record, with accurate estimation of internal organ volumes. MIA is becoming highly acceptable to parents and professionals, and there is widespread political support and public interest in its clinical implementation in the UK. In the short to medium term, it is desirable that a supraregional network of specialist centres should be established to provide this service within the current National Health Service framework.

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Section: The Mri Autopsy Studymentioning

confidence: 96%

Section: Minimally Invasive Autopsy: Adjunct or Alternative?mentioning

confidence: 99%

Section: The Mri Autopsy Studymentioning

confidence: 99%

Section: The Mri Autopsy Studymentioning

confidence: 99%

See 2 more Smart Citations

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Addison¹,

Arthurs²,

Thayyil³

2014

BJR

View full text Add to dashboard Cite

show abstract

“…In a recent article in the Lancet, Thayyil et al (18) analysed 400 cases, of which 277 (69%) were fetuses and 123 (31%) were children. Cause of death or major pathological lesion detected by minimally invasive autopsy was concordant with conventional autopsy in 357.…”

Section: Considerations Specific To Perinatal Pathologymentioning

confidence: 99%

The future of pediatric and perinatal postmortem imaging

et al. 2015

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The field and applications of post-mortem imaging are exponentially growing. Its potential to identify the cause of death in trauma and ballistic cases is now properly documented, as well as its use in drug mules identification. In pediatric and perinatal practice, large significant series are less available, except for MRI and central nervous system analysis where scientific evidence is now robust. In this review, after a short historical review and analysis of current problems and challenges, we will try to depict the way we see the future of this sub-specialty of post-mortem cross sectional, including in the scope all specific situations : terminations of pregnancy, intrauterine death, sudden unexpected infant death, and identification issues.

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Interventions for investigating and identifying the causes of stillbirth

Wojcieszek

Shepherd

Middleton

et al. 2018

Cochrane Database of Systematic Reviews

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There is currently a lack of RCT evidence regarding the effectiveness of interventions for investigating and identifying the causes of stillbirth. Seeking to determine the causes of stillbirth is an essential component of quality maternity care, but it remains unclear what impact these interventions have on the psychosocial outcomes of parents and families, the rates of diagnosis of the causes of stillbirth, and the care and management of subsequent pregnancies following stillbirth. Due to the absence of trials, this review is unable to inform clinical practice regarding the investigation of stillbirths, and the specific investigations that would determine the causes.Future RCTs addressing this research question would be beneficial, but the settings in which the trials take place, and their design, need to be given careful consideration. Trials need to be conducted with the utmost care and consideration for the needs, concerns, and values of parents and families. Assessment of longer-term psychosocial variables, economic costs to health services, and effects on subsequent pregnancy care and outcomes should also be considered in any future trials.

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Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study

Cited by 256 publications

References 27 publications

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

The future of pediatric and perinatal postmortem imaging

Interventions for investigating and identifying the causes of stillbirth

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