Article Text
Abstract
Objective Ultrasound is ubiquitous in live paediatric imaging; however, its usage in post-mortem setting is less established. This systematic review aims to evaluate the diagnostic accuracy of paediatric post-mortem ultrasound (PMUS).
Design MEDLINE, Embase and Cochrane Library databases were queried for studies published between 1998 and 2018 assessing PMUS diagnostic accuracy rates in children<18 years old, using autopsy as reference standard. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2. A bivariate random-effects model was used to obtain combined mean estimates of sensitivity and specificity for different body systems.
Results Four studies were included, all relating to ultrasound for perinatal deaths. The mean diagnostic sensitivity and specificity for neurological abnormalities were 84.3% (95% CI: 70.8% to 92.2%) and 96.7% (95% CI: 86.5% to 99.3%); for cardiothoracic abnormalities 52.1% (95% CI: 27.6% to 75.5%,) and 96.6% (95% CI: 86.8% to 99.2%); and for abdominal abnormalities 78.4% (95% CI: 61.0% to 89.4%) and 97.3% (95% CI: 88.9% to 99.4%). Combining all body systems, the mean sensitivity and specificity were 73.3% (95% CI: 59.9% to 83.5%) and 96.6% (95% CI: 92.6% to 98.4%).
Conclusions PMUS demonstrates a reasonable diagnostic accuracy, particularly for abdominal and neurological abnormalities, although cardiac anomalies were less readily identified.
Trial registration number CRD42018106968.
- autopsy
- minimally invasive autopsy
- paediatric
- perinatal
- ultrasound
- Autopsy
- minimally invasive autopsy
- paediatric
- perinatal
- ultrasound
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Footnotes
Contributors All authors listed in this manuscript fulfil the ICMJE recommendations for authorship. All authors provided substantial contribution to the conception and design of the work, analysis and interpretation; and drafting the work for intellectual content. All authors have had final approval for the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy are appropriately investigated and resolved.
Funding SCS is supported by a RCUK/ UKRI Innovation Fellowship and Medical Research Council (MRC) Clinical Research Training Fellowship (Grant Ref: MR/R00218/1). This award is jointly funded by the Royal College of Radiologists (RCR). OJA is funded by a National Institute for Health Research (NIHR) Career Development Fellowship (NIHR-CDF-2017-10-037), and NJS funded by an NIHR Senior Investigator award. The authors receive funding from the Great Ormond Street Children’s Charity and the Great Ormond Street Hospital NIHR Biomedical Research Centre. This article presents independent research funded by the MRC, RCR, NIHR and the views expressed are those of the author(s) and not necessarily those of the NHS, MRC, RCR, the NIHR or the Department of Health.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Institutional review board approval was not required because it comprises a systematic review of published literature.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.