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Master Thesis

Corrélations et apports respectifs de l’imagerie post mortem et de l’autopsie dans les morts inattendues du nourrisson

Abstract : Background: Post-mortem Computed Tomography (pmCT) and Magnetic Resonance Imaging (pmMRI) could be useful non-invasive methods in the management of Sudden Unexpected Deaths in Infant (SUDI), whether in addition to autopsy or in case of refusal. Our main objective was to study the concordance between the data found at post-mortem imaging and autopsy. The secondary objectives were to identify taphonomic changes and look for specific imaging signs related to final etiological diagnosis. Methods: We carried out a retrospective descriptive study concerning the deaths recorded by our SUDI reference center. Inclusion in the protocol concerned children aged 0 to 2 years who had undergone autopsy with concomitant pmCT and pmMRI. Imaging findings were compared with each other and compared to autopsy and final diagnoses retained. Concordance between the different diagnostic modalities (pmCT, pmMRI, autopsy) and agreement between the positive signs on imaging and the final diagnoses were assessed. Findings: From January 1, 2011 to December 31, 2016, 49 infants were included. Post-mortem imaging has shown notable performances in the detection of acute surgical pathologies. A good correlation was found between intracranial hemorrhage on imaging and inflicted trauma, hepatic steatosis and metabolic disease, cerebral ventricular dilatation and malformative pathology, cardiomegaly and cardiorespiratory failure. Thrombosed endocranial venous sinuses, intravascular sedimentation, spontaneous hyperdensity of the aortic wall, intravascular gas and bowel gas distension have been retained as taphonomic changes. Interpretation: PmCT and pmMRI are useful, non-invasive and acceptable complements to autopsy, especially if the latter is refused. Imaging participates in “first-line” urgent diagnoses : inflicted trauma, acute abdominal surgical conditions. Imaging also plays a significant role in highlighting metabolic diseases and malformative syndromes. However, to date, it does not provide relevant information for certain organs (cardiovascular system) or for the analysis of the lung parenchyma.
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Submitted on : Tuesday, November 12, 2019 - 2:05:38 PM
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THESE MANCHON 23-05-19.pdf
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Aurélie Manchon. Corrélations et apports respectifs de l’imagerie post mortem et de l’autopsie dans les morts inattendues du nourrisson. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02359510⟩



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