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  • Journal article
    Addison S, Arthurs O, Lally P, Alavi A, Taylor A, Sebire NJ, Thayyil Set al., 2014,

    PFM.25 Assessment of visceral maceration using post-mortem magnetic resonance imaging in fetuses.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1

    Post-mortem magnetic resonance imaging (PM MRI) is increasingly used as an alternative for perinatal autopsy, however the artefacts related to maceration has not been described.

  • Journal article
    Addison S, Munroe P, Mein C, Cohen M, Fowler D, Sebire NJ, Peebles D, Taylor A, Abrams D, Thayyil Set al., 2014,

    8.2 cardiac ion channelopathies in unexplained stillbirths.

    , Arch Dis Child Fetal Neonatal Ed, Vol: 99 Suppl 1

    Although cardiac ion channelopathies are reported in up to 15% of sudden infant deaths, the prevalence in unexplained stillbirths is not known.

  • Journal article
    Taylor AM, Sebire NJ, Ashworth MT, Schievano S, Scott RJ, Wade A, Chitty LS, Robertson N, Thayyil Set al., 2014,

    Postmortem cardiovascular magnetic resonance imaging in fetuses and children a masked comparison study with conventional autopsy

    , Circulation, Vol: 129, Pages: 1937-1944, ISSN: 0009-7322

    Background—Perinatal and pediatric autopsies have declined worldwide in the past decade. We compared the diagnostic accuracy of postmortem, cardiovascular magnetic resonance (CMR) imaging with conventional autopsy and histopathology assessment in fetuses and children.Methods and Results—We performed postmortem magnetic resonance imaging in 400 fetuses and children, using a 1.5-T Siemens Avanto magnetic resonance scanner before conventional autopsy. A pediatric CMR imager reported the CMR images, masked to autopsy information. The pathologists were masked to the information from CMR images. The institutional research ethics committee approved the study, and parental consent was obtained. Assuming a diagnostic accuracy of 50%, 400 cases were required for a 5% precision of estimate. Three cases were excluded from analysis, 2 with no conventional autopsy performed and 1 with insufficient CMR sequences performed. Thirty-eight CMR data sets were nondiagnostic (37 in fetuses ≤24 weeks; 1 in a fetus >24 weeks). In the remaining 359 cases, 44 cardiac abnormalities were noted at autopsy. Overall sensitivity and specificity (95% confidence interval) of CMR was 72.7% (58.2–83.7%) and 96.2% (93.5–97.8%) for detecting any cardiac pathology, with positive and negative predictive values of 72.7% (58.2–83.7%) and 96.2% (93.5–97.8%), respectively. Higher sensitivity of 92.6% (76.6–97.9%), specificity of 99.1% (97.4–99.7%), positive predictive value of 89.3% (72.8–96.3%), and negative predictive value of 99.4% (97.8–99.8%) were seen for major structural heart disease.Conclusions—Postmortem CMR imaging may be a useful alternative to conventional cardiac autopsy in fetuses and children for detecting cardiac abnormalities.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01417962.

  • Journal article
    Addison S, Arthurs OJ, Thayyil S, 2014,

    Post-mortem MRI as an alternative to non-forensic autopsy in foetuses and children: from research into clinical practice

    , BRITISH JOURNAL OF RADIOLOGY, Vol: 87, ISSN: 0007-1285
  • Journal article
    Lally PJ, Price DL, Pauliah SS, Bainbridge A, Kurien J, Sivasamy N, Cowan FM, Balraj G, Ayer M, Satheesan K, Ceebi S, Wade A, Swamy R, Padinjattel S, Hutchon B, Vijayakumar M, Nair M, Padinharath K, Zhang H, Cady EB, Shankaran S, Thayyil Set al., 2014,

    Neonatal encephalopathic cerebral injury in south india assessed by perinatal magnetic resonance biomarkers and early childhood neurodevelopmental outcome

    , PLOS One, Vol: 9, ISSN: 1932-6203

    Although brain injury after neonatal encephalopathy has been characterised well in high-income countries, little is known about such injury in low- and middle-income countries. Such injury accounts for an estimated 1 million neonatal deaths per year. We used magnetic resonance (MR) biomarkers to characterise perinatal brain injury, and examined early childhood outcomes in South India.MethodsWe recruited consecutive term or near term infants with evidence of perinatal asphyxia and a Thompson encephalopathy score ≥6 within 6 h of birth, over 6 months. We performed conventional MR imaging, diffusion tensor MR imaging and thalamic proton MR spectroscopy within 3 weeks of birth. We computed group-wise differences in white matter fractional anisotropy (FA) using tract based spatial statistics. We allocated Sarnat encephalopathy stage aged 3 days, and evaluated neurodevelopmental outcomes aged 3½ years using Bayley III.ResultsOf the 54 neonates recruited, Sarnat staging was mild in 30 (56%); moderate in 15 (28%) and severe in 6 (11%), with no encephalopathy in 3 (6%). Six infants died. Of the 48 survivors, 44 had images available for analysis. In these infants, imaging indicated perinatal rather than established antenatal origins to injury. Abnormalities were frequently observed in white matter (n = 40, 91%) and cortex (n = 31, 70%) while only 12 (27%) had abnormal basal ganglia/thalami. Reduced white matter FA was associated with Sarnat stage, deep grey nuclear injury, and MR spectroscopy N-acetylaspartate/choline, but not early Thompson scores. Outcome data were obtained in 44 infants (81%) with 38 (79%) survivors examined aged 3½ years; of these, 16 (42%) had adverse neurodevelopmental outcomes.ConclusionsNo infants had evidence for established brain lesions, suggesting potentially treatable perinatal origins. White matter injury was more common than deep brain nuclei injury. Our results support the need for rigorous evaluation of the efficacy of rescue

  • Journal article
    Robertson NJ, Thayyil S, Cady EB, Raivich Get al., 2014,

    Magnetic resonance spectroscopy biomarkers in term perinatal asphyxial encephalopathy: from neuropathological correlates to future clinical applications.

    , Curr Pediatr Rev, Vol: 10, Pages: 37-47

    Neonatal brain injury remains a devastating condition, with poor outcomes despite the institution of an effective neuroprotective strategy of therapeutic hypothermia. There is an urgent need to develop additional neuroprotective strategies and to tailor our clinical predictive ability for families and their infants. Such goals could be more readily achieved if reliable early clinical indicators or biomarkers existed. This review will explore the relation between magnetic resonance (MR) imaging biomarkers and the degree of brain pathology observed in our translational piglet model of perinatal asphyxia. We also suggest biomarker relevance at a cellular level. The review will describe the development needed to optimize and simplify the use of biomarkers to speed up future trials of neuroprotection.

  • Journal article
    Thayyil S, Sebire NJ, Chitty LS, 2013,

    Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study (vol 382, pg 223, 2013)

    , LANCET, Vol: 382, Pages: 1980-1980, ISSN: 0140-6736
  • Journal article
    Thayyil S, Sebire NJ, Chitty LS, 2013,

    Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study (vol 382, pg 223, 2013)

    , LANCET, Vol: 382, Pages: 208-208, ISSN: 0140-6736
  • Journal article
    Thayyil S, Sebire NJ, Chitty LS, Wade A, Chong WK, Olsen O, Gunny RS, Offiah AC, Owens CM, Saunders DE, Scott RJ, Jones R, Norman W, Addison S, Bainbridge A, Cady EB, De Vita E, Robertson NJ, Taylor AMet al., 2013,

    Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study

    , LANCET, Vol: 382, Pages: 223-233, ISSN: 0140-6736
  • Journal article
    Thayyil S, Sebire NJ, Chitty LS, 2013,

    Post-mortem MRI versus conventional autopsy in fetuses and children: a prospective validation study (vol 382, pg 223, 2013)

    , LANCET, Vol: 382, Pages: 208-208, ISSN: 0140-6736

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