PDF(Pubmed)
Abstract：
UNASSIGNED: Magnetic resonance imaging (MRI) has been used increasingly as an adjunct examination to ultrasound (US) for the evaluation of fetal anomalies. The purpose of this study was to determine whether the accuracy and confidence of diagnosing fetal vertebral anomalies are improved with MRI. We also assessed whether fetal MRI provides additional information when diagnosing fetal vertebral anomalies.
UNASSIGNED: We performed a single-center, retrospective study of 127 pregnant women with fetuses suspected of having vertebral anomalies on US examination; women also underwent fetal MRI scanning. Comparisons of diagnostic accuracy and confidence were made between MRI and US for the identification of fetal vertebral anomalies. We also assessed any additional information provided by MRI. McNemar\'s paired binomial test, chi-square test, or Fisher\'s exact test were used to compare the diagnostic ability between MRI and US. In all cases, postnatal or postmortem imaging findings were used as reference standards.
UNASSIGNED: A total of 127 participants were recruited between December 2015 and January 2021. Fetal vertebral anomalies were detected in 63.8% (81/127) cases and found to be negative in 36.2% (46/127) of cases at follow up. The diagnostic accuracy of vertebral anomalies was 46.9% (38/81) for US and 84.0% (68/81) for MRI [difference, 37.1%; 95% confidence interval (CI): 27% to 48%; P<0.001]. Both MRI and US were concordant and correct in 36.2% (46/127) of fetuses; MRI provided additional information for 16.5% (21/127) of fetuses, and corrected US diagnoses of 36.2% (46/127) of fetuses; both MRI and US were not consistent with postnatal findings in 10.2% (13/127) of fetuses, and the remaining fetus (0.8%, 1/127) was diagnosed correctly using US but failed to be diagnosed by MRI. Diagnoses were reported with high confidence using MRI in 95.3% (121/127) of cases and 73.2% (93/127) using US.
UNASSIGNED: Fetal vertebral MRI improves the accuracy and confidence of diagnosing fetal vertebral anomalies. This finding indicates that fetal MRI supplements the information provided by US and that MRI may be a good complement in selected fetuses, when US can either not achieve a definite diagnosis or there is doubt regarding its reliability. Thus, MRI may be used to inform prenatal counseling and management decisions.
UNASSIGNED: We performed a single-center, retrospective study of 127 pregnant women with fetuses suspected of having vertebral anomalies on US examination; women also underwent fetal MRI scanning. Comparisons of diagnostic accuracy and confidence were made between MRI and US for the identification of fetal vertebral anomalies. We also assessed any additional information provided by MRI. McNemar\'s paired binomial test, chi-square test, or Fisher\'s exact test were used to compare the diagnostic ability between MRI and US. In all cases, postnatal or postmortem imaging findings were used as reference standards.
UNASSIGNED: A total of 127 participants were recruited between December 2015 and January 2021. Fetal vertebral anomalies were detected in 63.8% (81/127) cases and found to be negative in 36.2% (46/127) of cases at follow up. The diagnostic accuracy of vertebral anomalies was 46.9% (38/81) for US and 84.0% (68/81) for MRI [difference, 37.1%; 95% confidence interval (CI): 27% to 48%; P<0.001]. Both MRI and US were concordant and correct in 36.2% (46/127) of fetuses; MRI provided additional information for 16.5% (21/127) of fetuses, and corrected US diagnoses of 36.2% (46/127) of fetuses; both MRI and US were not consistent with postnatal findings in 10.2% (13/127) of fetuses, and the remaining fetus (0.8%, 1/127) was diagnosed correctly using US but failed to be diagnosed by MRI. Diagnoses were reported with high confidence using MRI in 95.3% (121/127) of cases and 73.2% (93/127) using US.
UNASSIGNED: Fetal vertebral MRI improves the accuracy and confidence of diagnosing fetal vertebral anomalies. This finding indicates that fetal MRI supplements the information provided by US and that MRI may be a good complement in selected fetuses, when US can either not achieve a definite diagnosis or there is doubt regarding its reliability. Thus, MRI may be used to inform prenatal counseling and management decisions.
摘要：
■磁共振成像（MRI）已越来越多地用作超声（US）的辅助检查，以评估胎儿畸形。这项研究的目的是确定MRI是否可以提高诊断胎儿椎骨异常的准确性和置信度。我们还评估了胎儿MRI在诊断胎儿椎骨异常时是否提供了其他信息。
■我们执行了单中心，回顾性研究了127名孕妇的胎儿在US检查中怀疑有椎骨异常;妇女还接受了胎儿MRI扫描。在MRI和US之间进行了诊断准确性和置信度的比较，以鉴定胎儿椎骨异常。我们还评估了MRI提供的任何其他信息。McNemar的配对二项式检验,卡方检验,或Fisher精确检验用于比较MRI和US的诊断能力。在所有情况下,出生后或死后影像学检查结果被用作参考标准.
■2015年12月至2021年1月共招募了127名参与者。63.8%(81/127)的胎儿椎体异常，随访中36.2%(46/127)的胎儿椎体异常为阴性。椎体异常的诊断准确率US为46.9%(38/81),MRI为84.0%(68/81)[差异,37.1%；95%置信区间（CI）：27%至48%；P<0.001]。在36.2%（46/127）的胎儿中，MRI和US都是一致和正确的；MRI为16.5%（21/127）的胎儿提供了额外的信息，和纠正的美国诊断36.2%(46/127)的胎儿;MRI和US与10.2%(13/127)的胎儿的产后发现不一致,和剩余的胎儿(0.8%，1/127）使用US正确诊断，但MRI未能诊断。使用MRI高度可信地报告了95.3%(121/127)的病例和使用US的73.2%(93/127)的病例。
■胎儿椎体MRI提高了诊断胎儿椎体异常的准确性和置信度。这一发现表明，胎儿MRI补充了美国提供的信息，MRI可能是选定胎儿的良好补充，当US无法获得明确的诊断或对其可靠性有疑问时。因此，MRI可用于告知产前咨询和管理决策。
■我们执行了单中心，回顾性研究了127名孕妇的胎儿在US检查中怀疑有椎骨异常;妇女还接受了胎儿MRI扫描。在MRI和US之间进行了诊断准确性和置信度的比较，以鉴定胎儿椎骨异常。我们还评估了MRI提供的任何其他信息。McNemar的配对二项式检验,卡方检验,或Fisher精确检验用于比较MRI和US的诊断能力。在所有情况下,出生后或死后影像学检查结果被用作参考标准.
■2015年12月至2021年1月共招募了127名参与者。63.8%(81/127)的胎儿椎体异常，随访中36.2%(46/127)的胎儿椎体异常为阴性。椎体异常的诊断准确率US为46.9%(38/81),MRI为84.0%(68/81)[差异,37.1%；95%置信区间（CI）：27%至48%；P<0.001]。在36.2%（46/127）的胎儿中，MRI和US都是一致和正确的；MRI为16.5%（21/127）的胎儿提供了额外的信息，和纠正的美国诊断36.2%(46/127)的胎儿;MRI和US与10.2%(13/127)的胎儿的产后发现不一致,和剩余的胎儿(0.8%，1/127）使用US正确诊断，但MRI未能诊断。使用MRI高度可信地报告了95.3%(121/127)的病例和使用US的73.2%(93/127)的病例。
■胎儿椎体MRI提高了诊断胎儿椎体异常的准确性和置信度。这一发现表明，胎儿MRI补充了美国提供的信息，MRI可能是选定胎儿的良好补充，当US无法获得明确的诊断或对其可靠性有疑问时。因此，MRI可用于告知产前咨询和管理决策。
