Concordancia entre la resonancia magnética post mortem y la autopsia clínica en la detección de malformaciones mayores en cadáveres de fetos y neonatos.

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Title:	Concordancia entre la resonancia magnética post mortem y la autopsia clínica en la detección de malformaciones mayores en cadáveres de fetos y neonatos.
Alternate Title:	Comparison of Postmortem Magnetic Resonance Imaging and Clinical Autopsy in Detection of Major Congenital Abnormalities in Corpses of Fetus and Infants.
Authors:	MONTES LOAIZA, GUILLERMO ANDRÉS¹ gmontex@hotmail.com, ESCALANTE ABRIL, PAOLA ANDREA², URIZA CARRASCO, LUIS FELIPE³, OLAYA CONTRERAS, MERCEDES⁴, RIVERA MARIÑO, DIEGO MIGUEL⁵, DE CASTRO ASÍS, ALFREDO FERNÁNDEZ⁵, GIL LAVERDE, FABIÁN ARMANDO⁶
Source:	Universitas Médica. ene-mar2014, Vol. 55 Issue 1, p10-17. 8p.
Subjects:	AUTOPSY, HUMAN abnormalities, DIAGNOSTIC imaging research, CAUSES of fetal death, NEONATAL death, MAGNETIC resonance imaging, CONGENITAL disorders, DIAGNOSIS
Abstract (English):	Introduction: The use of diagnostic imaging in clinical and forensic autopsies, is a practice that is taking place in countries other than our own, especially in autopsies of particular difficulty such as fetuses and neonates. It is important to know the correlation between magnetic resonance imaging postmortem and clinical autopsy to recommend its routine use in our midst. Materials and methods: Autopsies performed on 20 fetuses and neonates and took total body MRI thereof, comparing imaging findings with autopsy findings. Information obtained was tabulated and Kappa value was rated to determine the concordance between the two diagnostic methods. Results: We calculated the correlation between MRI and clinical autopsy in detecting major malformations per system, calculating a kappa index for major malformations in the central nervous system of 0.273, for head and neck of 0.459, to the respiratory system of 0, for cardiovascular system from 0.459, for the gastrointestinal tract and the abdomen of 0, and urinary system of 0.643. Conclusions: Despite the poor correlation between MRI and postmortem clinical autopsy in detecting major malformations is considered in this case to the clinical autopsy as an imperfect gold standard and recommended the use of magnetic resonance imaging study mode can support a clinical autopsy in detecting major malformations in difficult cases in fetuses and neonates. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	Introducción: La utilización de imágenes diagnósticas en autopsias clínicas y médicolegales es una práctica que viene llevándose a cabo en países diferentes al nuestro, en especial en autopsias de particular dificultad como las de fetos y neonatos. Es importante conocer la concordancia entre la resonancia magnética post mortem y la autopsia clínica para recomendar su uso rutinario en nuestro medio. Materiales y métodos: Se realizó autopsia a 20 fetos y neonatos y se tomó resonancia magnética corporal total, comparando los hallazgos por imágenes con los hallazgos de la autopsia. Se tabuló la información obtenida y se calculó el valor kappa nominal para determinar la concordancia entre los dos métodos diagnósticos. Resultados: Se calculó la concordancia entre la resonancia magnética y la autopsia clínica en la detección de malformaciones mayores por sistema, calculando un índice de kappa para malformaciones mayores en sistema nervioso central de 0,273, para cabeza y cuello de 0,459, para sistema respiratorio de 0, para sistema cardiovascular de 0,459, para tubo digestivo y abdomen de 0 y para sistema urinario de 0,643. Conclusiones: A pesar de la mala concordancia entre la resonancia magnética post mortem y la autopsia clínica en la detección de malformaciones mayores, se considera en este caso la autopsia clínica como un patrón de referencia imperfecto y se recomienda el uso de la resonancia como modalidad de estudio que puede servir de apoyo a la autopsia clínica en la detección de malformaciones mayores en casos difíciles en fetos y neonatos. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

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Abstract:	Introduction: The use of diagnostic imaging in clinical and forensic autopsies, is a practice that is taking place in countries other than our own, especially in autopsies of particular difficulty such as fetuses and neonates. It is important to know the correlation between magnetic resonance imaging postmortem and clinical autopsy to recommend its routine use in our midst. Materials and methods: Autopsies performed on 20 fetuses and neonates and took total body MRI thereof, comparing imaging findings with autopsy findings. Information obtained was tabulated and Kappa value was rated to determine the concordance between the two diagnostic methods. Results: We calculated the correlation between MRI and clinical autopsy in detecting major malformations per system, calculating a kappa index for major malformations in the central nervous system of 0.273, for head and neck of 0.459, to the respiratory system of 0, for cardiovascular system from 0.459, for the gastrointestinal tract and the abdomen of 0, and urinary system of 0.643. Conclusions: Despite the poor correlation between MRI and postmortem clinical autopsy in detecting major malformations is considered in this case to the clinical autopsy as an imperfect gold standard and recommended the use of magnetic resonance imaging study mode can support a clinical autopsy in detecting major malformations in difficult cases in fetuses and neonates. [ABSTRACT FROM AUTHOR]
ISSN:	00419095