Comparison between MRI and the Combination of 2D and 3D US in the Prenatal Diagnosis of Closed Spina Bifida.

IF 0.9 4区医学 Q4 CLINICAL NEUROLOGY Pediatric Neurosurgery Pub Date : 2023-01-01 Epub Date: 2023-09-12 DOI:10.1159/000533205

Weiping Zhang, Jingling Wang, Hui Wu, Li Chen

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Abstract

Introduction: Closed spina bifida (CSB) is a rare condition with a challenging prenatal diagnosis. Herein, we assess the conventional two-dimensional (2D) ultrasound (US) combined with three-dimensional (3D) ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal diagnosis of CSB.

Methods: In this retrospective study, we included 20 cases of fetal CSB confirmed by postnatal MRI, post-mortem pathological examination, or postpartum surgery. Prenatal 2D US complemented with the 3D US was performed in all fetuses to evaluate the characteristics of the conus, vertebral arch, and scoliosis. Moreover, MRI was performed to establish the split vertebrae, with or without a bulging mass. Thereafter, we compared the performance of the US and MRI.

Results: Diagnosis accuracy of US was comparable with MRI (70% vs. 75%, κ = 0.62); US detected more cases with interpediculate distance ≥95% (55% vs. 35%, κ = 0.22) than MRI. On the other hand, MRI had a superior capacity for identifying vertebral arch fissures (20% vs. 35%, κ = 0.39). MRI and ultrasound had good agreement in the conus medullaris (65% vs. 70%, κ = 0.42) and scoliosis (45% vs. 35%, κ = 0.59). Both US and MRI detected 1 (5.0%) case with "lemon sign" and "banana sign." The missed diagnosis rates of US and MRI were 15% (3/20) and 5% (1/20), respectively. The misdiagnosis rates of US and MRI were 15.0% (3/20) and 20.0% (4/20), respectively.

Conclusion: Both MRI and 2D US combined with the 3D US had excellent performance in prenatal diagnosis of CSB.

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在闭合性脊柱裂产前诊断中核磁共振成像与二维和三维超声相结合的比较

简介闭合性脊柱裂（CSB）是一种罕见疾病，产前诊断极具挑战性。在此，我们评估了常规二维（2D）超声（US）结合三维（3D）超声（US）和磁共振成像（MRI）在 CSB 产前诊断中的应用：在这项回顾性研究中，我们纳入了20例经产后磁共振成像、死后病理检查或产后手术证实的胎儿CSB。我们对所有胎儿进行了产前二维和三维超声检查，以评估锥体、椎弓和脊柱侧弯的特征。此外，还进行了核磁共振成像，以确定椎体是否分裂，有无膨出肿块。之后，我们比较了 US 和 MRI 的性能：结果：US 的诊断准确率与 MRI 相当（70% 对 75%，κ = 0.62）；US 比 MRI 检测出更多椎间距离≥95% 的病例（55% 对 35%，κ = 0.22）。另一方面，核磁共振成像在识别椎弓根裂隙方面能力更强（20% 对 35%，κ = 0.39）。磁共振成像和超声波在髓圆锥（65% 对 70%，κ = 0.42）和脊柱侧弯（45% 对 35%，κ = 0.59）方面具有良好的一致性。US 和 MRI 均发现了 1 例（5.0%）"柠檬征 "和 "香蕉征 "病例。US 和 MRI 的漏诊率分别为 15%（3/20）和 5%（1/20）。US 和 MRI 的误诊率分别为 15.0%（3/20）和 20.0%（4/20）：结论：核磁共振成像、二维 US 和三维 US 在 CSB 产前诊断中均表现出色。

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来源期刊

Pediatric Neurosurgery 医学-临床神经学

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Articles in ''Pediatric Neurosurgery'' strives to publish new information and observations in pediatric neurosurgery and the allied fields of neurology, neuroradiology and neuropathology as they relate to the etiology of neurologic diseases and the operative care of affected patients. In addition to experimental and clinical studies, the journal presents critical reviews which provide the reader with an update on selected topics as well as case histories and reports on advances in methodology and technique. This thought-provoking focus encourages dissemination of information from neurosurgeons and neuroscientists around the world that will be of interest to clinicians and researchers concerned with pediatric, congenital, and developmental diseases of the nervous system.