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Routine perinatal and paediatric post-mortem radiography: detection rates and implications for practice.
Owen J Arthurs1, Alistair D Calder, Liina Kiho
1Department of Radiology Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N 3JH, UK, owen.arthurs@gosh.nhs.uk.
Routine post-mortem radiography for infants is not cost-effective. A selective imaging approach is recommended to improve diagnostic yield and reduce costs.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Forensic Pathology
Background:
- Routine perinatal and pediatric post-mortem plain radiography is used to diagnose skeletal abnormalities.
- The diagnostic yield of this practice is not well-established.
Purpose of the Study:
- To review the diagnostic yield of routine post-mortem radiography in perinatal and pediatric cases.
Main Methods:
- 1,027 cases over 2.5 years were reviewed, including babygrams and skeletal surveys.
- Radiology findings were cross-referenced with autopsy findings.
- Cases were scored for diagnostic usefulness.
Main Results:
- Overall abnormality rate was 12.3%. Skeletal surveys had a higher abnormality rate (18%) than babygrams (10%).
- Routine imaging identified significant abnormalities in only 0.27% of cases.
- A selective imaging policy could lead to significant cost savings.
Conclusions:
- Routine post-mortem pediatric radiography is neither diagnostically useful nor cost-effective.
- An evidence-based, selective protocol is recommended for significant cost savings.
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