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.
Bibliographical noteFunding Information:
This work was undertaken at Great Ormond Street Hospital and University College Hospital, London who received a proportion of funding from the United Kingdom Department of Health's NIHR Biomedical Research Centres funding scheme. ST is funded by the UK Department of Health and Comprehensive Biomedical Research Centre, University College Hospital. AMT is funded by the National Institute of Health Research (NIHR) (SRF/08/01/018). NJR, NJS and JSW are funded by Higher Education Funding Council for England.
- Economic evaluation
- Magnetic resonance imaging
- Parental attitudes
- Systematic review