METHODS: This was an IRB-approved retrospective study of consecutive patients with suspected fetal MSK anomalies examined between December 2015 and June 2020. We compared individual MSK and non-MSK anomalies identified via US, MRI, and CT with postnatal outcomes. Sensitivity and specificity for US and MRI were calculated and compared.
RESULTS: A total of 31 patients with 112 MSK and 43 non-MSK anomalies were included. The sensitivity of MRI and US for MSK anomalies was not significantly different (76.6% vs. 61.3%, p = 0.3). Low-dose CT identified eight additional skeletal anomalies. MRI diagnosed a higher number of non-MSK anomalies compared to US (81.4% vs. 37.2%, p < 0.05).
CONCLUSIONS: Fetal MRI and US have comparable sensitivity for MSK anomalies. In selected cases, low-dose CT may provide additional information. Fetal MRI detected a larger number of non-MSK anomalies in other organ systems compared to US. Multimodality imaging combining all the information provided by MRI, US, and CT, if necessary, ultimately achieved a sensitivity of 89.2% (95% CI: 83.4% to 95.0%) for the diagnosis of musculoskeletal anomalies and 81.4% for additional anomalies in other organs and systems.
方法:这是IRB批准的一项回顾性研究,对2015年12月至2020年6月期间检查的疑似胎儿MSK异常的连续患者进行了回顾性研究。我们比较了通过US识别的单个MSK和非MSK异常,MRI,和CT与产后结局。计算并比较了US和MRI的敏感性和特异性。
结果:共纳入31例患者112例MSK和43例非MSK异常。MRI和US对MSK异常的敏感性没有显着差异(76.6%与61.3%,p=0.3)。低剂量CT识别出8个额外的骨骼异常。与美国相比,MRI诊断的非MSK异常数量更高(81.4%vs.37.2%,p<0.05)。
结论:胎儿MRI和US对MSK异常具有相当的敏感性。在某些情况下,低剂量CT可以提供更多信息。与美国相比,胎儿MRI在其他器官系统中检测到更多的非MSK异常。多模态成像结合了MRI提供的所有信息,US,CT,如有必要,最终对肌肉骨骼异常的诊断敏感度为89.2%(95%CI:83.4%~95.0%),对其他器官和系统的其他异常的诊断敏感度为81.4%.