Potential clinical benefits and limitations of fetal virtopsy using high‐field MRI at 7 Tesla versus stereomicroscopic autopsy to assess first trimester fetuses
Objective The aim of this study was to establish the diagnostic accuracy of high‐field magnetic resonance imaging (MRI) at 7 Tesla (T) compared with that of stereomicroscopic autopsy for assessing first trimester fetuses. Methods Nine consecutive cases of first trimester fetuses resulting from spont...
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| Veröffentlicht in: | Prenatal diagnosis 2019-06, Vol.39 (7), p.505-518 |
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| creator | Staicu, Adelina Albu, Camelia Popa‐Stanila, Roxana Chiriac, Liviu Boitor‐Borza, Dan Bondor, Cosmina Kovacs, Tunde Caracostea, Gabriela Rotar, Ioana Cristina Turcu, R.V. Flaviu Simon, Simion Muresan, Daniel Stamatian, Florin |
| description | Objective
The aim of this study was to establish the diagnostic accuracy of high‐field magnetic resonance imaging (MRI) at 7 Tesla (T) compared with that of stereomicroscopic autopsy for assessing first trimester fetuses.
Methods
Nine consecutive cases of first trimester fetuses resulting from spontaneous and therapeutic pregnancy termination were considered. The cases were divided into two groups according to gestational age: the Embryo Group with cases of nine to 10 gestational weeks (GWs) and the Fetus Group with cases of 13 GWs. The first group was scanned using three‐dimensional fast imaging with steady state precession (3D FISP), and the second group was scanned using a two‐dimensional (2D) turbo spin‐echo high‐resolution T2‐weighted imaging (T2 WI) protocol. A radiologist and two embryologists interpreted the images. All cases were evaluated by invasive autopsy, with pathologist blinded to the imaging results. In total, the database included 270 items for evaluation (9 cases × 30 structures/case).
Results
The global agreement between fetal high‐field virtopsy and microscopic or stereomicroscopic autopsy was evaluated using 225 evaluation items visible by both methods. Overall, using microscopic examination and stereomicroscopic autopsy as the gold standard, fetal high‐field virtopsy had a sensitivity of 94.6% [95% CI, 87.2‐98.3] and a specificity of 97.6% [95% CI, 95‐98.8]. The positive predictive value (PPV) was 93% [95% CI, 85.7‐96.6], and the negative predictive value (NPV) was 98.2% [95% CI, 95.7‐99.4]. Cohen kappa coefficient of agreement was k = 0.92 [95% CI, 0.82‐0.97], and the McNemar test showed p = 1.00.
Conclusions
Virtual autopsy using high‐field MRI at 7 T can be considered a safe alternative approach to stereomicroscopic autopsy for the assessment of fetal structural anomalies at the end of the first trimester of pregnancy.
What is already known about this topic?
Widespread clinical magnetic resonance imaging (MRI) at 1.5 T and 3 T has been shown to have limited usefulness in evaluating small fetuses. To satisfy the need for accurate imaging in these cases, recent studies on postmortem microfocus computed tomography and high‐field MRI have demonstrated valuable results. However, few studies have explored the potential of these methods in first trimester fetuses.
What does this study add?
High‐field MRI at 7 T represents a useful tool for the assessment of first trimester cases, having the ability to visualize embryonic and small fetal |
| doi_str_mv | 10.1002/pd.5457 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2209611539</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2237432143</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3787-f73b36af15a39ef881407053e3a7892547788989c4560148b24da8d9e0cbafad3</originalsourceid><addsrcrecordid>eNp10dFqFTEQBuAgFnus4htIwAsFOTXZZE-SS6laCxWL1OsluztpU7KbNZOtnDsfoc_QR_NJmu2pXgheZSAf_8wwhLzg7JAzVr2b-sNa1uoRWXFm1JpVlXhMVoyXWuia75OniFcF6sqoJ2RfMKOZ5GJFbs9ihjF7G2gX_Oi7UrQwgvMZqR17Gvzgs80-jkijow5yEdc-5Tjhls7oxwt66S8uf_-6cR5CT798O6E2U0XPAYOl15BwRooZEsTBdyliFyffUTvvInKkFhEQqfMJM83JD7DwpddcPp6RPWcDwvOH94B8__Tx_Ojz-vTr8cnR-9N1J5RWa6dEKzbW8doKA05rLplitQBhlTZVLZXS2mjTyXrDuNRtJXurewOsa62zvTggb3a5U4o_5jJCM3jsIAQ7QpyxqSpmNpzXwhT66h96Fec0lumKEkqKiktR1OudWpbGBK6Zym42bRvOmuVszdQ3y9mKfPmQN7cD9H_dnzsV8HYHfvoA2__lNGcf7uPuALIKo1I</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2237432143</pqid></control><display><type>article</type><title>Potential clinical benefits and limitations of fetal virtopsy using high‐field MRI at 7 Tesla versus stereomicroscopic autopsy to assess first trimester fetuses</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Staicu, Adelina ; Albu, Camelia ; Popa‐Stanila, Roxana ; Chiriac, Liviu ; Boitor‐Borza, Dan ; Bondor, Cosmina ; Kovacs, Tunde ; Caracostea, Gabriela ; Rotar, Ioana Cristina ; Turcu, R.V. Flaviu ; Simon, Simion ; Muresan, Daniel ; Stamatian, Florin</creator><creatorcontrib>Staicu, Adelina ; Albu, Camelia ; Popa‐Stanila, Roxana ; Chiriac, Liviu ; Boitor‐Borza, Dan ; Bondor, Cosmina ; Kovacs, Tunde ; Caracostea, Gabriela ; Rotar, Ioana Cristina ; Turcu, R.V. Flaviu ; Simon, Simion ; Muresan, Daniel ; Stamatian, Florin</creatorcontrib><description>Objective
The aim of this study was to establish the diagnostic accuracy of high‐field magnetic resonance imaging (MRI) at 7 Tesla (T) compared with that of stereomicroscopic autopsy for assessing first trimester fetuses.
Methods
Nine consecutive cases of first trimester fetuses resulting from spontaneous and therapeutic pregnancy termination were considered. The cases were divided into two groups according to gestational age: the Embryo Group with cases of nine to 10 gestational weeks (GWs) and the Fetus Group with cases of 13 GWs. The first group was scanned using three‐dimensional fast imaging with steady state precession (3D FISP), and the second group was scanned using a two‐dimensional (2D) turbo spin‐echo high‐resolution T2‐weighted imaging (T2 WI) protocol. A radiologist and two embryologists interpreted the images. All cases were evaluated by invasive autopsy, with pathologist blinded to the imaging results. In total, the database included 270 items for evaluation (9 cases × 30 structures/case).
Results
The global agreement between fetal high‐field virtopsy and microscopic or stereomicroscopic autopsy was evaluated using 225 evaluation items visible by both methods. Overall, using microscopic examination and stereomicroscopic autopsy as the gold standard, fetal high‐field virtopsy had a sensitivity of 94.6% [95% CI, 87.2‐98.3] and a specificity of 97.6% [95% CI, 95‐98.8]. The positive predictive value (PPV) was 93% [95% CI, 85.7‐96.6], and the negative predictive value (NPV) was 98.2% [95% CI, 95.7‐99.4]. Cohen kappa coefficient of agreement was k = 0.92 [95% CI, 0.82‐0.97], and the McNemar test showed p = 1.00.
Conclusions
Virtual autopsy using high‐field MRI at 7 T can be considered a safe alternative approach to stereomicroscopic autopsy for the assessment of fetal structural anomalies at the end of the first trimester of pregnancy.
What is already known about this topic?
Widespread clinical magnetic resonance imaging (MRI) at 1.5 T and 3 T has been shown to have limited usefulness in evaluating small fetuses. To satisfy the need for accurate imaging in these cases, recent studies on postmortem microfocus computed tomography and high‐field MRI have demonstrated valuable results. However, few studies have explored the potential of these methods in first trimester fetuses.
What does this study add?
High‐field MRI at 7 T represents a useful tool for the assessment of first trimester cases, having the ability to visualize embryonic and small fetal structures, even in cases with moderate autolysis. This imaging approach may obtain the postmortem information necessary to guide genetic and proteomic investigations for the management of future pregnancies with a major impact not only on future pregnancies but also on the psychological health of the family.</description><identifier>ISSN: 0197-3851</identifier><identifier>EISSN: 1097-0223</identifier><identifier>DOI: 10.1002/pd.5457</identifier><identifier>PMID: 30980413</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aborted Fetus - diagnostic imaging ; Aborted Fetus - pathology ; Anomalies ; Autopsies ; Autopsy ; Autopsy - methods ; Depth Perception ; Diagnostic systems ; Embryos ; Evaluation ; Female ; Fetal Death ; Fetus - diagnostic imaging ; Fetus - pathology ; Fetuses ; Gestational Age ; Humans ; Imaging, Three-Dimensional - methods ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Medical imaging ; Microscopy - methods ; NMR ; Nuclear magnetic resonance ; Predictive Value of Tests ; Pregnancy ; Pregnancy Trimester, First ; Sensitivity and Specificity</subject><ispartof>Prenatal diagnosis, 2019-06, Vol.39 (7), p.505-518</ispartof><rights>2019 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3787-f73b36af15a39ef881407053e3a7892547788989c4560148b24da8d9e0cbafad3</citedby><cites>FETCH-LOGICAL-c3787-f73b36af15a39ef881407053e3a7892547788989c4560148b24da8d9e0cbafad3</cites><orcidid>0000-0003-3755-320X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpd.5457$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpd.5457$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30980413$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Staicu, Adelina</creatorcontrib><creatorcontrib>Albu, Camelia</creatorcontrib><creatorcontrib>Popa‐Stanila, Roxana</creatorcontrib><creatorcontrib>Chiriac, Liviu</creatorcontrib><creatorcontrib>Boitor‐Borza, Dan</creatorcontrib><creatorcontrib>Bondor, Cosmina</creatorcontrib><creatorcontrib>Kovacs, Tunde</creatorcontrib><creatorcontrib>Caracostea, Gabriela</creatorcontrib><creatorcontrib>Rotar, Ioana Cristina</creatorcontrib><creatorcontrib>Turcu, R.V. Flaviu</creatorcontrib><creatorcontrib>Simon, Simion</creatorcontrib><creatorcontrib>Muresan, Daniel</creatorcontrib><creatorcontrib>Stamatian, Florin</creatorcontrib><title>Potential clinical benefits and limitations of fetal virtopsy using high‐field MRI at 7 Tesla versus stereomicroscopic autopsy to assess first trimester fetuses</title><title>Prenatal diagnosis</title><addtitle>Prenat Diagn</addtitle><description>Objective
The aim of this study was to establish the diagnostic accuracy of high‐field magnetic resonance imaging (MRI) at 7 Tesla (T) compared with that of stereomicroscopic autopsy for assessing first trimester fetuses.
Methods
Nine consecutive cases of first trimester fetuses resulting from spontaneous and therapeutic pregnancy termination were considered. The cases were divided into two groups according to gestational age: the Embryo Group with cases of nine to 10 gestational weeks (GWs) and the Fetus Group with cases of 13 GWs. The first group was scanned using three‐dimensional fast imaging with steady state precession (3D FISP), and the second group was scanned using a two‐dimensional (2D) turbo spin‐echo high‐resolution T2‐weighted imaging (T2 WI) protocol. A radiologist and two embryologists interpreted the images. All cases were evaluated by invasive autopsy, with pathologist blinded to the imaging results. In total, the database included 270 items for evaluation (9 cases × 30 structures/case).
Results
The global agreement between fetal high‐field virtopsy and microscopic or stereomicroscopic autopsy was evaluated using 225 evaluation items visible by both methods. Overall, using microscopic examination and stereomicroscopic autopsy as the gold standard, fetal high‐field virtopsy had a sensitivity of 94.6% [95% CI, 87.2‐98.3] and a specificity of 97.6% [95% CI, 95‐98.8]. The positive predictive value (PPV) was 93% [95% CI, 85.7‐96.6], and the negative predictive value (NPV) was 98.2% [95% CI, 95.7‐99.4]. Cohen kappa coefficient of agreement was k = 0.92 [95% CI, 0.82‐0.97], and the McNemar test showed p = 1.00.
Conclusions
Virtual autopsy using high‐field MRI at 7 T can be considered a safe alternative approach to stereomicroscopic autopsy for the assessment of fetal structural anomalies at the end of the first trimester of pregnancy.
What is already known about this topic?
Widespread clinical magnetic resonance imaging (MRI) at 1.5 T and 3 T has been shown to have limited usefulness in evaluating small fetuses. To satisfy the need for accurate imaging in these cases, recent studies on postmortem microfocus computed tomography and high‐field MRI have demonstrated valuable results. However, few studies have explored the potential of these methods in first trimester fetuses.
What does this study add?
High‐field MRI at 7 T represents a useful tool for the assessment of first trimester cases, having the ability to visualize embryonic and small fetal structures, even in cases with moderate autolysis. This imaging approach may obtain the postmortem information necessary to guide genetic and proteomic investigations for the management of future pregnancies with a major impact not only on future pregnancies but also on the psychological health of the family.</description><subject>Aborted Fetus - diagnostic imaging</subject><subject>Aborted Fetus - pathology</subject><subject>Anomalies</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>Autopsy - methods</subject><subject>Depth Perception</subject><subject>Diagnostic systems</subject><subject>Embryos</subject><subject>Evaluation</subject><subject>Female</subject><subject>Fetal Death</subject><subject>Fetus - diagnostic imaging</subject><subject>Fetus - pathology</subject><subject>Fetuses</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional - methods</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medical imaging</subject><subject>Microscopy - methods</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, First</subject><subject>Sensitivity and Specificity</subject><issn>0197-3851</issn><issn>1097-0223</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10dFqFTEQBuAgFnus4htIwAsFOTXZZE-SS6laCxWL1OsluztpU7KbNZOtnDsfoc_QR_NJmu2pXgheZSAf_8wwhLzg7JAzVr2b-sNa1uoRWXFm1JpVlXhMVoyXWuia75OniFcF6sqoJ2RfMKOZ5GJFbs9ihjF7G2gX_Oi7UrQwgvMZqR17Gvzgs80-jkijow5yEdc-5Tjhls7oxwt66S8uf_-6cR5CT798O6E2U0XPAYOl15BwRooZEsTBdyliFyffUTvvInKkFhEQqfMJM83JD7DwpddcPp6RPWcDwvOH94B8__Tx_Ojz-vTr8cnR-9N1J5RWa6dEKzbW8doKA05rLplitQBhlTZVLZXS2mjTyXrDuNRtJXurewOsa62zvTggb3a5U4o_5jJCM3jsIAQ7QpyxqSpmNpzXwhT66h96Fec0lumKEkqKiktR1OudWpbGBK6Zym42bRvOmuVszdQ3y9mKfPmQN7cD9H_dnzsV8HYHfvoA2__lNGcf7uPuALIKo1I</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Staicu, Adelina</creator><creator>Albu, Camelia</creator><creator>Popa‐Stanila, Roxana</creator><creator>Chiriac, Liviu</creator><creator>Boitor‐Borza, Dan</creator><creator>Bondor, Cosmina</creator><creator>Kovacs, Tunde</creator><creator>Caracostea, Gabriela</creator><creator>Rotar, Ioana Cristina</creator><creator>Turcu, R.V. Flaviu</creator><creator>Simon, Simion</creator><creator>Muresan, Daniel</creator><creator>Stamatian, Florin</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3755-320X</orcidid></search><sort><creationdate>201906</creationdate><title>Potential clinical benefits and limitations of fetal virtopsy using high‐field MRI at 7 Tesla versus stereomicroscopic autopsy to assess first trimester fetuses</title><author>Staicu, Adelina ; Albu, Camelia ; Popa‐Stanila, Roxana ; Chiriac, Liviu ; Boitor‐Borza, Dan ; Bondor, Cosmina ; Kovacs, Tunde ; Caracostea, Gabriela ; Rotar, Ioana Cristina ; Turcu, R.V. Flaviu ; Simon, Simion ; Muresan, Daniel ; Stamatian, Florin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3787-f73b36af15a39ef881407053e3a7892547788989c4560148b24da8d9e0cbafad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aborted Fetus - diagnostic imaging</topic><topic>Aborted Fetus - pathology</topic><topic>Anomalies</topic><topic>Autopsies</topic><topic>Autopsy</topic><topic>Autopsy - methods</topic><topic>Depth Perception</topic><topic>Diagnostic systems</topic><topic>Embryos</topic><topic>Evaluation</topic><topic>Female</topic><topic>Fetal Death</topic><topic>Fetus - diagnostic imaging</topic><topic>Fetus - pathology</topic><topic>Fetuses</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional - methods</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medical imaging</topic><topic>Microscopy - methods</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, First</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Staicu, Adelina</creatorcontrib><creatorcontrib>Albu, Camelia</creatorcontrib><creatorcontrib>Popa‐Stanila, Roxana</creatorcontrib><creatorcontrib>Chiriac, Liviu</creatorcontrib><creatorcontrib>Boitor‐Borza, Dan</creatorcontrib><creatorcontrib>Bondor, Cosmina</creatorcontrib><creatorcontrib>Kovacs, Tunde</creatorcontrib><creatorcontrib>Caracostea, Gabriela</creatorcontrib><creatorcontrib>Rotar, Ioana Cristina</creatorcontrib><creatorcontrib>Turcu, R.V. Flaviu</creatorcontrib><creatorcontrib>Simon, Simion</creatorcontrib><creatorcontrib>Muresan, Daniel</creatorcontrib><creatorcontrib>Stamatian, Florin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Prenatal diagnosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Staicu, Adelina</au><au>Albu, Camelia</au><au>Popa‐Stanila, Roxana</au><au>Chiriac, Liviu</au><au>Boitor‐Borza, Dan</au><au>Bondor, Cosmina</au><au>Kovacs, Tunde</au><au>Caracostea, Gabriela</au><au>Rotar, Ioana Cristina</au><au>Turcu, R.V. Flaviu</au><au>Simon, Simion</au><au>Muresan, Daniel</au><au>Stamatian, Florin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Potential clinical benefits and limitations of fetal virtopsy using high‐field MRI at 7 Tesla versus stereomicroscopic autopsy to assess first trimester fetuses</atitle><jtitle>Prenatal diagnosis</jtitle><addtitle>Prenat Diagn</addtitle><date>2019-06</date><risdate>2019</risdate><volume>39</volume><issue>7</issue><spage>505</spage><epage>518</epage><pages>505-518</pages><issn>0197-3851</issn><eissn>1097-0223</eissn><abstract>Objective
The aim of this study was to establish the diagnostic accuracy of high‐field magnetic resonance imaging (MRI) at 7 Tesla (T) compared with that of stereomicroscopic autopsy for assessing first trimester fetuses.
Methods
Nine consecutive cases of first trimester fetuses resulting from spontaneous and therapeutic pregnancy termination were considered. The cases were divided into two groups according to gestational age: the Embryo Group with cases of nine to 10 gestational weeks (GWs) and the Fetus Group with cases of 13 GWs. The first group was scanned using three‐dimensional fast imaging with steady state precession (3D FISP), and the second group was scanned using a two‐dimensional (2D) turbo spin‐echo high‐resolution T2‐weighted imaging (T2 WI) protocol. A radiologist and two embryologists interpreted the images. All cases were evaluated by invasive autopsy, with pathologist blinded to the imaging results. In total, the database included 270 items for evaluation (9 cases × 30 structures/case).
Results
The global agreement between fetal high‐field virtopsy and microscopic or stereomicroscopic autopsy was evaluated using 225 evaluation items visible by both methods. Overall, using microscopic examination and stereomicroscopic autopsy as the gold standard, fetal high‐field virtopsy had a sensitivity of 94.6% [95% CI, 87.2‐98.3] and a specificity of 97.6% [95% CI, 95‐98.8]. The positive predictive value (PPV) was 93% [95% CI, 85.7‐96.6], and the negative predictive value (NPV) was 98.2% [95% CI, 95.7‐99.4]. Cohen kappa coefficient of agreement was k = 0.92 [95% CI, 0.82‐0.97], and the McNemar test showed p = 1.00.
Conclusions
Virtual autopsy using high‐field MRI at 7 T can be considered a safe alternative approach to stereomicroscopic autopsy for the assessment of fetal structural anomalies at the end of the first trimester of pregnancy.
What is already known about this topic?
Widespread clinical magnetic resonance imaging (MRI) at 1.5 T and 3 T has been shown to have limited usefulness in evaluating small fetuses. To satisfy the need for accurate imaging in these cases, recent studies on postmortem microfocus computed tomography and high‐field MRI have demonstrated valuable results. However, few studies have explored the potential of these methods in first trimester fetuses.
What does this study add?
High‐field MRI at 7 T represents a useful tool for the assessment of first trimester cases, having the ability to visualize embryonic and small fetal structures, even in cases with moderate autolysis. This imaging approach may obtain the postmortem information necessary to guide genetic and proteomic investigations for the management of future pregnancies with a major impact not only on future pregnancies but also on the psychological health of the family.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30980413</pmid><doi>10.1002/pd.5457</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0003-3755-320X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Prenatal diagnosis, 2019-06, Vol.39 (7), p.505-518 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aborted Fetus - diagnostic imaging Aborted Fetus - pathology Anomalies Autopsies Autopsy Autopsy - methods Depth Perception Diagnostic systems Embryos Evaluation Female Fetal Death Fetus - diagnostic imaging Fetus - pathology Fetuses Gestational Age Humans Imaging, Three-Dimensional - methods Magnetic resonance imaging Magnetic Resonance Imaging - methods Medical imaging Microscopy - methods NMR Nuclear magnetic resonance Predictive Value of Tests Pregnancy Pregnancy Trimester, First Sensitivity and Specificity |
| title | Potential clinical benefits and limitations of fetal virtopsy using high‐field MRI at 7 Tesla versus stereomicroscopic autopsy to assess first trimester fetuses |
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