Background: Postmortem analysis of fetal heart is crucial but challenging. Alternative techniques to autopsy have been studied. We investigate micro-CT diagnostic accuracy in the analysis of fetal heart coming from early and late termination of pregnancy. Methods: Micro-CT and autopsy analyzed human fetal heart using twenty-six indices of cardiac anatomy derived from segmental approach. Sub-analysis of smaller specimens was performed. Primary outcome is the agreement between techniques. Secondary outcomes are sensitivity, specificity, positive and negative predictive value. Indices are defined “visible” or “non-visible” (primary end point) and “normal”, “abnormal” or “non-diagnostic” (secondary end point). Results: Fifty-five cases were included. Agreement was 74.5% and 65.2% for primary end point and 93.3% and 91.8% for secondary end point in general population and in the group of smaller specimens, respectively. Sensitivity, specificity, positive and negative predictive value were 92.8%, 51.8%, 67.1%, 87.2% in the general population and 92.8%, 47.8%, 54.3%, 90.9% in the subgroup of smaller specimens for primary end point. They were 97.3%, 68.3%, 95.1%, 80.0% in the general population and 95.7%, 75.6%, 94.2%, 81.0% in the subgroup of smaller specimens for secondary end point. 86.1% and 91.5% of indices defined as “non-diagnostic” at autopsy would be visible by micro-CT in the two studied populations. Conclusion: Micro-CT represents a valid alternative to autopsy for postmortem evaluation of human fetal heart. We proposed to use micro-CT for initial analysis of fetal heart and to perform autopsy only in unsolved cases or if histological analysis is needed.
What can we learn from systematic segmental analysis of fetal heart by postmortem micro-CT: Is it time to change approach?
R. Raffaelli;M. P. Franchi;N. Papadopoulos;A. Murari;L. Chamitava;M. E. Zanolin;G. Faggian;F. L. Ribichini;G. B. Luciani
2022-01-01
Abstract
Background: Postmortem analysis of fetal heart is crucial but challenging. Alternative techniques to autopsy have been studied. We investigate micro-CT diagnostic accuracy in the analysis of fetal heart coming from early and late termination of pregnancy. Methods: Micro-CT and autopsy analyzed human fetal heart using twenty-six indices of cardiac anatomy derived from segmental approach. Sub-analysis of smaller specimens was performed. Primary outcome is the agreement between techniques. Secondary outcomes are sensitivity, specificity, positive and negative predictive value. Indices are defined “visible” or “non-visible” (primary end point) and “normal”, “abnormal” or “non-diagnostic” (secondary end point). Results: Fifty-five cases were included. Agreement was 74.5% and 65.2% for primary end point and 93.3% and 91.8% for secondary end point in general population and in the group of smaller specimens, respectively. Sensitivity, specificity, positive and negative predictive value were 92.8%, 51.8%, 67.1%, 87.2% in the general population and 92.8%, 47.8%, 54.3%, 90.9% in the subgroup of smaller specimens for primary end point. They were 97.3%, 68.3%, 95.1%, 80.0% in the general population and 95.7%, 75.6%, 94.2%, 81.0% in the subgroup of smaller specimens for secondary end point. 86.1% and 91.5% of indices defined as “non-diagnostic” at autopsy would be visible by micro-CT in the two studied populations. Conclusion: Micro-CT represents a valid alternative to autopsy for postmortem evaluation of human fetal heart. We proposed to use micro-CT for initial analysis of fetal heart and to perform autopsy only in unsolved cases or if histological analysis is needed.File | Dimensione | Formato | |
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