PDF(Pubmed)
Abstract：
BACKGROUND: Ultrasonography (US) is the first-line diagnostic tool used to assess fetal musculoskeletal (MSK) anomalies. Associated anomalies in other organ systems may benefit from evaluation via Magnetic Resonance Imaging (MRI). In this study, we compared the diagnostic accuracy of US and MRI to diagnose fetal MSK (primary objective) and non-MSK anomalies (secondary objective). We describe additional findings by low-dose computerized tomography (CT) in two cases incompletely characterized via US and MRI.
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.
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.
摘要：
背景：超声检查（US）是用于评估胎儿肌肉骨骼（MSK）异常的一线诊断工具。其他器官系统中的相关异常可能受益于通过磁共振成像（MRI）进行的评估。在这项研究中,我们比较了US和MRI诊断胎儿MSK(主要目标)和非MSK异常(次要目标)的准确性.我们通过低剂量计算机断层扫描（CT）描述了通过US和MRI未完全表征的两个病例的其他发现。
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%.
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%.
