1/4/2024 0 Comments Rmn bucurestiIn the last decades, numerous small studies have reported post-mortem MRI as a potential alternative to conventional autopsy (9). This has led to the development of numerous noninvasive post-mortem examination techniques, such as post-mortem magnetic resonance imaging (MRI), post-mortem ultrasound, and various techniques involving computed tomography (CT) (6) and microcomputed tomography for cardiac structural evaluation (7,8). A complete post-mortem diagnosis is required for the proper counseling of future pregnancies. However, a sustained decline in autopsy consent rates has been observed worldwide in the last decade, due to either religious or personal concerns of the parents regarding the autopsy process (5). Though challenging, currently worldwide fetal cardiac dissection techniques can successfully follow the sequential segmental analysis system and visualize any structural abnormalities (3,4). Autopsy continues to be the gold standard for post-mortem examination. Utilizând RMN-ul post-mortem de 7T pentru evaluarea morfometrică tridimensională a cordului fetal la feţii de trimestrul al doilea, cu greutate corporală mai mică de 500 g, se obţin rezultate comparabile cu cele ale măsurătorilor macroscopice efectuate în timpul autopsiei convenţionale.Ĭongenital heart disease continues to be a frequent cause of mortality and morbidity among children (1), with a prevalence of 81.70 (80.87-82.54)/10.000 births, according to EUROCAT data (2). Graficele Bland Altman au arătat o asociere în general bună între măsurătorile efectuate prin ambele metode. Coeficientul de corelaţie (r) pentru toate cele trei axe măsurate a fost mai mare sau egal cu 0,90. S-a observat o corelaţie puternică între măsurătorile RMN post-mortem la 7T şi măsurătorile efectuate la autopsie, cu p<0,001. Măsurătorile cardiace pe trei axe au fost efectuate prin ambele metode de examinare, folosind aceleaşi repere. După examinarea imagistică post-mortem, toate cazurile au fost supuse autopsiei convenţionale. Toate cazurile au fost fixate corespunzător în soluţie de formaldehidă 10%, iar ulterior au fost examinate folosind un aparat RMN de 7T. Toţi feţii au rezultat în urma întreruperii terapeutice a sarcinii (TOP) din cauza unor sindroame plurimalformative sau a prezenţei anomaliilor cromozomiale. Au fost luaţi în considerare 12 feţi de trimestrul al doilea, cu vârsta gestaţională cuprinsă între 13 şi 19 săptămâni de amenoree. Scopul studiului nostru a fost de a stabili dacă RMN-ul post-mortem la 7T poate efectua măsurători tridimensionale ale inimii fetale şi dacă poate obţine rezultate comparabile cu ale măsurătorilor macroscopice post-mortem efectuate la autopsie, la feţii cu greutate corporală mai mică de 500 g. Using 7T post-mortem MRI for three-dimensional morphometric evaluation of the fetal heart in the second-trimester fetuses with a body weight less than 500 g, the obtained results are comparable to the macroscopic measurements performed during conventional autopsy. Bland Altman plots showed overall good agreement between measurements performed by both methods. The coefficient of correlation (r) for all three axes was above or equal to 0.90. We observed a strong correlation between post-mortem MRI measurements at 7T and post-mortem macroscopic measurements at autopsy, with p<0.001. Three-axis cardiac measurements were performed by both examination methods, using the same landmarks. After post-mortem imagistic examination, all cases were submitted to conventional autopsy. All cases were immersed in 10% formalin solution, and after proper fixation they were examined using high-field MRI at 7T. All fetuses resulted from therapeutic termination of pregnancy (TOP) due to plurimalformative syndromes or chromosomal anomalies. Twelve second-trimester fetuses with gestational ages ranging from 13 to 19 weeks of gestation were considered. The aim of our study was to establish if high-field post-mortem MRI at 7T can perform three-dimensional measurements of the fetal heart, and retrieve results comparable to post-mortem macroscopic measurements performed at autopsy, in fetuses with whole body weight below 500 g.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |