Intrauterine fetal MR versus postmortem MR imaging after therapeutic termination of pregnancy: evaluation of the concordance in the detection of brain abnormalities at early gestational stage

Izzo, Giana; Talenti, Giacomo; Falanga, Giorgia; Moscatelli, Marco; Conte, Giorgio; Scola, Elisa; Doneda, Chiara; Parazzini, Cecilia; Rustico, Mariangela; Triulzi, Fabio; Righini, Andrea

doi:10.1007/s00330-018-5878-0

Cited by 18 publications

(17 citation statements)

References 29 publications

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“…Izzo et al. suggest a close concordance between post‐mortem MRI and iuMRI for fetal brain pathology, 22 which in conjunction with our results suggests that iuMRI should be considered a reliable indicator of brain abnormalities in the fetus when a formal post‐mortem examination is not performed or is unsuccessful.…”

Section: Discussionsupporting

confidence: 87%

Post‐mortem confirmation of fetal brain abnormalities: challenges highlighted by the MERIDIAN cohort study

Griffiths

Jarvis

Mooney

et al. 2021

BJOG

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Objectives To assess and analyse the concordance between post‐mortem findings and in utero magnetic resonance imaging (iuMRI) in the MERIDIAN (MRI to enhance the diagnosis of fetal developmental brain abnormalities in utero) cohort. Design Prospective cohort study. Setting Fetal medicine units in the UK. Population Pregnant women with a diagnosis of fetal brain abnormality identified on ultrasound at 18 weeks of gestation or later. Methods All pregnancies from the MERIDIAN study that resulted in a abortion were included and the rate of uptake and success of post‐mortem examinations were calculated. In the cases in which diagnostic information about the fetal brain was obtained by post‐mortem, the results were compared with the diagnoses from iuMRI. Main outcome measure Outcome reference diagnosis from post‐mortem examination. Results A total of 155 from 823 pregnancies (19%) ended in a termination of pregnancy and 71 (46%) had post‐mortem brain examinations, 62 of which were diagnostically adequate. Hence, the overall rate of successful post‐mortem investigation was 40%, and for those cases there was a concordance rate of 84% between iuMRI and post‐mortem examination. Detailed information is provided when the results of the post‐mortem examination and the iuMRI study differed. Conclusions We have shown tissue‐validation of radiological diagnosis is hampered by a low rate of post‐mortem studies in fetuses aborted with brain abnormalities, a situation further compounded by a 12% rate of autopsy being technically unsuccessful. The agreement between iuMRI and post‐mortem findings is high, but our analysis of the discrepant cases provides valuable clues for improving how we provide information for parents. Tweetable abstract iuMRI should be considered a reliable indicator of fetal brain abnormalities when post‐mortem is not performed.

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Section: Discussionsupporting

confidence: 87%

Post‐mortem confirmation of fetal brain abnormalities: challenges highlighted by the MERIDIAN cohort study

Griffiths

Jarvis

Mooney

et al. 2021

BJOG

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“…5) The value of an international program to help support countries and demonstrate the value of paediatric postmortem MRI to governments and insurance companies. 6) One centre has shown that paediatric postmortem MRI is not as accurate as intrauterine foetal MRI for central nervous system cases [17], a finding supported by another study [18]. Consequently, the centre is now using intrauterine foetal MRI as a first step in postmortem investigations when there is an intention to terminate the pregnancy due to a foetal cranial abnormality.…”

Section: Imaging Protocols (Table 2)mentioning

confidence: 99%

Current state of perinatal postmortem magnetic resonance imaging: European Society of Paediatric Radiology questionnaire-based survey and recommendations

et al. 2020

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Background Postmortem magnetic resonance imaging (MRI) in perinatal and childhood deaths is increasingly used as a noninvasive adjunct or alternative to autopsy. Imaging protocols vary between centres and consensus guidelines do not exist. Objective Our aim was to develop practical, standardised recommendations for perinatal postmortem MRI. Materials and methods Recommendations were based on the results of two surveys regarding local postmortem MRI practices sent electronically to all 14 members of the European Society of Paediatric Radiology (ESPR) Postmortem Imaging Task Force and 17 members of the International Society of Forensic Radiology and Imaging Task Force (25 different centres). Results Overall, 11/14 (78.6%) respondents from different institutions perform postmortem MRI. All of these centres perform postmortem MRI for perinatal and neonatal deaths, but only 6/11 (54.5%) perform imaging in older children. Conclusion We propose a clinical standard for postmortem MRI sequences plus optional sequences for neuroimaging and cardiac anatomy depending on available scanning time and referral indications.

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“…This hopefully will improve not only CFA detection but also prognostication of possible long-term neurodevelopmental sequelae. However, post-natal follow-up or post-mortem MR-autopsy are still strongly advised, when possible (27).…”

Section: Cortical Formation Anomaliesmentioning

confidence: 99%

Brain fetal neuroradiology: a beginner’s guide

Moltoni¹,

Talenti²,

Righini³

2021

Transl Pediatr

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Intrauterine fetal MR versus postmortem MR imaging after therapeutic termination of pregnancy: evaluation of the concordance in the detection of brain abnormalities at early gestational stage

Cited by 18 publications

References 29 publications

Post‐mortem confirmation of fetal brain abnormalities: challenges highlighted by the MERIDIAN cohort study

Post‐mortem confirmation of fetal brain abnormalities: challenges highlighted by the MERIDIAN cohort study

Current state of perinatal postmortem magnetic resonance imaging: European Society of Paediatric Radiology questionnaire-based survey and recommendations

Brain fetal neuroradiology: a beginner’s guide

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