Postmortem fetal organ volumetry using magnetic resonance imaging and comparison to organ weights at conventional autopsy
Postmortem fetal organ volumetry using magnetic resonance imaging and comparison to organ weights at conventional autopsy
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DOI：
10.1002/uog.5199
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发表时间：
2008-02-01
影响因子：
7.1
通讯作者：
Lees, C. C.
中科院分区：
文献类型：
--
作者：
Breeze, A. C. G.;Gallagher, F. A.;Lees, C. C.
目的围产期死亡后，尸检时的器官重量可以提供生长受限和肺发育不良的证据。虽然死后的磁共振成像（MRI）可以提供类似的信息解剖结构异常，其能力提供可重复的数据有关器官大小尚未确定。我们研究了使用死后MRI提供估计器官大小和weight.Methods 25胎龄从16至40周的胎儿进行尸检前尸检的可行性。胎儿肺，脑和肝体积估计由两名观察员使用体视学技术在死后MRI切片。尸检时记录胎仔肺、脑和肝脏重量。使用回归分析比较器官体积估计值和尸检器官重量，并估计胎儿器官密度。使用Bland-Altman图评估观察者间变异性。受试者工作特征曲线（ROC）分析比较MRI脑：肝体积比尸检脑：肝weight ratios.Results器官体积估计和器官重量之间的线性关系。胎儿脑、肝和肺的估计密度分别为1.08 g/cm（3）、1.15 g/cm（3）和1.15 g/cm（3）。胎儿脑、肝脏和肺的观察者间第5和第95百分位数一致性界限分别为-5.4%至+7.9%、-11.8%至+83%和-14.3%至+8.7%。当脑肝比>= 4时，MRI器官体积的ROC曲线下面积为0.61，最佳截断值为4.1。结论死后MRI器官体积可用于估计胎儿主要器官的重量。这可能会增加从微创围产期尸检中获得的信息，特别是在肺发育不全和宫内生长受限的情况下，其中差异性器官生长在评估潜在病理学中起着重要作用。Copyright（c）2007 ISUOG.由John Wiley & Sons有限公司出版
Objectives Following perinatal death, organ weights at autopsy may provide evidence of growth restriction and pulmonary hypoplasia. Whilst postmortem magnetic resonance imaging (MRI) may provide comparable information to autopsy about structural abnormalities, its ability to provide reproducible data about organ size has yet to be determined. We examined the feasibility of using postmortem MRI to provide estimates of organ size and weight.Methods Twenty-five fetuses of gestational age from 16 to 40 weeks underwent postmortem MRI prior to autopsy. Fetal lung, brain and liver volume estimations were performed by two observers using the stereology technique on postmortem MRI slices. Fetal lung, brain and liver weights were recorded at autopsy. Organ volume estimates and autopsy organ weights were compared using regression analysis, and estimates of fetal organ densities made. Interobserver variability was assessed using a Bland-Altman plot. Receiver-operating characteristics curve (ROC) analysis compared MRI brain: liver volume ratios to autopsy brain: liver weight ratios.Results A linear relationship between organ volume estimates and organ weight was observed. Estimated densities for the fetal brain, liver and lung were 1.08g/cm(3), 1.15g/cm(3) and 1.15g/cm(3), respectively. Interobserver 5(th) and 95(th) percentile limits of agreement for fetal brain, liver and lung were -5.4% to +7.9%, -11.8% to +83% and -14.3% to +8.7%, respectively. For MRI organ volumes to detect a brain weight:liver weight ratio >= 4, ROC analysis demonstrated an area under the curve of 0.61, with an optimal cut-off of 4.1.Conclusion Postmortem MRI organ volumetry can be used to estimate weights of major fetal organs. This may increase the information obtained from a minimally-invasive perinatal autopsy, particularly in the context of pulmonary hypoplasia and intrauterine growth restriction, where differential organ growth plays a major part in assessment of the underlying pathology. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.