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
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
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DOI：
10.1007/s00330-018-5878-0
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发表时间：
2019-06-01
影响因子：
5.9
通讯作者：
Righini, Andrea
中科院分区：
文献类型：
--
作者：
Izzo, Giana;Talenti, Giacomo;Righini, Andrea
背景和目的近年来，胎儿尸检磁共振成像(PmMRI)已被用作终止妊娠后常规脑部尸检的辅助工具。我们的目的是比较宫内磁共振成像(IuMRI)和pmMRI对早期妊娠(GA)胎儿脑异常的诊断能力。材料和方法我们回顾收集了53例疑似胎儿脑异常的宫内MRI和pmMRI检查。两位儿科神经放射科医生分别回顾了iuMRI和pmMRI检查，然后一起进行了检查。我们用Cohen‘s K来评估pmMRI和iuMRI之间的一致性。以联合评价iuMRI+pMRI为参考标准，计算正确率。我们用Somers‘s D来评估死后图像质量与胎儿排出后时间之间的一致性。结果我们的数据显示，考虑到所有类别，两个观察者的iuMRI和pmMRI具有很高的一致性(K1 0.84；K2 0.86)。IuMRI和pmMRI的诊断正确率分别为79%和45%。IuMRI和pmMRI的主要不同之处在于死后的变化，如液体结构的崩溃和扭曲现象。我们还发现，排出时间与pmMRI对比度分辨率和失真现象之间存在显著的相关性(均P
Background and purposeFetal postmortem MR Imaging (pmMRI) has been recently used as an adjuvant tool to conventional brain autopsy after termination of pregnancy (TOP). Our purpose was to compare the diagnostic performance of intrauterine MRI (iuMRI) and pmMRI in the detection of brain anomalies in fetuses at early gestational age (GA).Material and methodsWe retrospectively collected 53 fetuses who had undergone iuMRI and pmMRI for suspected brain anomalies. Two pediatric neuroradiologists reviewed iuMRI and pmMRI examinations separately and then together. We used Cohen's K to assess the agreement between pmMRI and iuMRI. Using the combined evaluation iuMRI+pMRI as the reference standard, we calculated the correctness ratio. We used Somers' D to assess the cograduation between postmortem image quality and time elapsed after fetus expulsion.ResultsOur data showed high agreement between iuMRI and pmMRI considering all the categories together, for both observers (K1 0.84; K2 0.86). The correctness ratio of iuMRI and pmMRI was 79% and 45% respectively. The major disagreements between iuMRI and pmMRI were related to postmortem changes as the collapse of liquoral structures and distorting phenomena. We also found a significant cograduation between the time elapsed from expulsion and pmMRI contrast resolution and distortive phenomena (both p