Journal
EUROPEAN JOURNAL OF RADIOLOGY
Volume 75, Issue 1, Pages E142-E148Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ejrad.2009.10.007
Keywords
Sensitivity; Specificity; Magnetic resonance imaging; Autopsy; Economic evaluation; Costing; Parental attitudes; Systematic review
Funding
- United Kingdom Department of Health's NIHR Biomedical Research Centres
- UK Department of Health and Comprehensive Biomedical Research Centre, University College Hospital
- National Institute of Health Research (NIHR) [SRF/08/01/018]
- Higher Education Funding Council for England
- Great Ormond Street Hospital Childrens Charity [V0912] Funding Source: researchfish
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To determine, in a systematic review, the diagnostic accuracy, acceptability and cost-effectiveness of less invasive autopsy by post-mortem MR imaging, in fetuses, children and adults. We searched Medline, Embase, the Cochrane library and reference lists to identify all studies comparing post-mortem MR imaging with conventional autopsy, published between January 1990 and March 2009. 539 abstracts were identified; 15 papers met the inclusion criteria; data from 9 studies were extracted (total: 146 fetuses, 11 children and 24 adults). In accurately identifying the final cause of death or most clinically significant abnormality, post-mortem MR imaging had a sensitivity and specificity of 69% (95% CI-56%, 80%) and 95% (95% CI-88%, 98%) in fetuses, and 28% (95% CI-13%, 47%) and 64% (95% CI-23%, 94%) in children and adults, respectively; however the published data is limited to small, heterogenous and poorly designed studies. Insufficient data is available on acceptability and economic evaluation of post-mortem MR imaging. Well designed, large, prospective studies are required to evaluate the accuracy of post-mortem MR imaging, before it can be offered as a clinical tool. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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