Organ volume measurements: comparison between MRI and autopsy findings in infants following sudden unexpected death

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 97; no. 6; pp. F434 - F438
• Main Authors: Prodhomme, Olivier, Seguret, Fabienne, Martrille, Laurent, Pidoux, Odile, Cambonie, Gilles, Couture, Alain, Rouleau, Caroline
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.11.2012; BMJ Publishing Group LTD
• Subjects: Autopsy; Female; Humans; Image Processing, Computer-Assisted; Infant; Infant, Newborn; Infants; Kidneys; Magnetic Resonance Imaging; Male; Organ Size; Prospective Studies; Sudden Infant Death - pathology
• ISSN: 1359-2998; 1468-2052; 1468-2052
• DOI: 10.1136/fetalneonatal-2011-301309

Objective To assess the accuracy of a semiautomated 3D volume reconstruction method for organ volume measurement by postmortem MRI. Methods This prospective study was approved by the institutional review board and the infants' parents gave their consent. Postmortem MRI was performed in 16 infants (1 month to 1 year of age) at 1.5 T within 48 h of their sudden death. Virtual organ volumes were estimated using the Myrian software. Real volumes were recorded at autopsy by water displacement. The agreement between virtual and real volumes was quantified following the Bland and Altman's method. Results There was a good agreement between virtual and real volumes for brain (mean difference: −0.03% (−13.6 to +7.1)), liver (+8.3% (−9.6 to +26.2)) and lungs (+5.5% (−26.6 to +37.6)). For kidneys, spleen and thymus, the MRI/autopsy volume ratio was close to 1 (kidney: 0.87±0.1; spleen: 0.99±0.17; thymus: 0.94±0.25), but with a less good agreement. For heart, the MRI/real volume ratio was 1.29±0.76, possibly due to the presence of residual blood within the heart. The virtual volumes of adrenal glands were significantly underestimated (p=0.04), possibly due to their very small size during the first year of life. The percentage of interobserver and intraobserver variation was lower or equal to 10%, but for thymus (15.9% and 12.6%, respectively) and adrenal glands (69% and 25.9%). Conclusions Virtual volumetry may provide significant information concerning the macroscopic features of the main organs and help pathologists in sampling organs that are more likely to yield histological findings.