Related Experiment Video
Updated: Dec 26, 2025
Murine Fetal Echocardiography
Published on: February 15, 2013
Diagnostic accuracy of postmortem ultrasound vs postmortem 1.5-T MRI for non-invasive perinatal autopsy
S C Shelmerdine1,2, N J Sebire2,3,4, O J Arthurs1,2,4
1Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, UK.
Objectives:
To determine the diagnostic accuracy of postmortem magnetic resonance imaging (PM-MRI) and postmortem ultrasound (PM-US) for perinatal autopsy in the same patient cohort, and to determine whether PM-US can provide the same anatomical information as PM-MRI.
Methods:
In this prospective, 5-year (July 2014-July 2019) single-center study, we performed 1.5-T PM-MRI and PM-US in an unselected cohort of perinatal deaths. The diagnostic accuracies of both modalities were calculated, using autopsy as the reference standard. As a secondary objective, the concordance rates between the two imaging modalities for the overall main diagnosis and for five anatomical regions (brain, spine, thorax, heart and abdomen) were calculated.
Results:
During the study period, 136 cases underwent both PM-US and PM-MRI, of which 88 (64.7%) also underwent autopsy. There was no significant difference in the rates of concordance with autopsy between the two modalities for overall diagnosis (PM-US, 86.4% (95% CI, 77.7-92.0%) vs PM-MRI, 88.6% (95% CI, 80.3-93.7%)) or in the sensitivities and specificities for individual anatomical regions. There were more non-diagnostic PM-US than PM-MRI examinations for the brain (22.8% vs 3.7%) and heart (14.7% vs 5.1%). If an 'imaging-only' autopsy had been performed, PM-US would have achieved the same diagnosis as 1.5-T PM-MRI in 86.8% (95% CI, 80.0-91.5%) of cases, with the highest rates of agreement being for spine (99.3% (95% CI, 95.9-99.9%)) and cardiac (97.3% (95% CI, 92.4-99.1%)) findings and the lowest being for brain diagnoses (85.2% (95% CI, 76.9-90.8%)).
Conclusion:
Although there were fewer non-diagnostic cases using PM-MRI than for PM-US, the high concordance rate for overall diagnosis suggests that PM-US could be used for triaging cases when PM-MRI access is limited or unavailable. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Insights
Postmortem ultrasound (PM-US) shows high diagnostic accuracy comparable to postmortem MRI (PM-MRI) for perinatal deaths. PM-US can serve as a valuable tool for initial assessment when PM-MRI is unavailable.
Area of Science:
- Medical Imaging
- Perinatal Pathology
- Diagnostic Accuracy
Background:
- Postmortem imaging is crucial for perinatal autopsies.
- Postmortem magnetic resonance imaging (PM-MRI) and postmortem ultrasound (PM-US) are emerging diagnostic tools.
- Comparing the diagnostic capabilities of PM-US and PM-MRI in perinatal cases is essential.
Purpose of the Study:
- To evaluate the diagnostic accuracy of PM-MRI and PM-US in perinatal autopsies.
- To compare the anatomical information provided by PM-US versus PM-MRI.
- To assess the concordance between PM-US and PM-MRI for overall and regional diagnoses.
Main Methods:
- Prospective, 5-year single-center study of perinatal deaths.
- 1.5-T PM-MRI and PM-US performed on an unselected cohort.
- Autopsy served as the reference standard for diagnostic accuracy and concordance analysis.
Main Results:
- No significant difference in overall diagnostic concordance with autopsy between PM-US (86.4%) and PM-MRI (88.6%).
- PM-MRI yielded fewer non-diagnostic examinations for the brain and heart compared to PM-US.
- High concordance between PM-US and PM-MRI for spine (99.3%) and cardiac (97.3%) findings.
Conclusions:
- PM-US demonstrates high diagnostic accuracy and concordance with PM-MRI in perinatal cases.
- PM-US can be a viable alternative for triaging cases, especially when PM-MRI access is limited.
- Further integration of PM-US in perinatal autopsy protocols is warranted.
