Fetal Postmortom Imaging (Virtopsy): A Comparative Study with Conventional Autopsy
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2017, Vol 2, Issue 3
Abstract
Introduction: Fetal autopsies are done in dead babies born or aborted with congenital anomalies to know the anatomic details of the anomaly and the syndromic assosciation to plan subsequent pregnancies. In patients who defer fetal autopsy due to cultural, religious, ethical and emotional reasons, virtopsy using CT and MR can be considered a safe alternative. Though many studies have proven that virtual autopsies are at par with conventional autopsies, limited data is available for limited data is available regarding the role of virtopsy in detecting fetal anomalies using CT and MRI. Study objectives were to evaluate the accuracy of Virtopsy in diagnosing congenital abnormalities in fetus by using CT and MRI and to compare virtopsy findings with conventional autopsy findings in fetuses. Material and Methods: This was a prospective study conducted on 30 fetuses over two years period. Whole body CT and MRI of expelled fetus was performed using 1.5T MRI scanner and 64-slice MDCT. The sensitivities, specificities and predictive values of post mortem virtopsy, were assessed with conventional autopsy as gold standard. Results: Findings were classified as neurological, renal, skeletal, cardiac, infective and miscellaneous subtypes, anatomical morphology was assessed and was compared with the conventional autopsy findings. This study showed 87.50% sensitivity, 50% specificity, 87.5% positive predictive value, 50% negative predictive value, positive likelihood ratio of 1.75 and negative likelihood ratio of 0.25.The diagnostic accuracy of this study is 80%. The chi squared test yielded p value of 0.03998. The chi-square statistics is 4.2188. The result is significant at p<0.05 Conclusion: Virtopsy can be used as diagnostic means in cases where the parents are unwilling to subject the fetus to autopsy for emotional, cultural, religious and ethical reasons. Virtopsy is particularly useful in detecting neurological and skeletal anomalies. Virtopsy cannot be used in assessing congenital complex cardiac anomalies
Authors and Affiliations
Shylaja Prashanth, Nishaa P, Vinutha L, Satish Prasad, Suresha B
Keywords
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