Cassart M, Massez A, Cos T, Tecco L, Thomas D, Van Regemorter N, Avni F
Department of Medical Imaging, Erasme University Clinics, and Department of Fetal Medicine, Brugmann Hospital, Brussels, Belgium.
Ultrasound Obstet Gynecol. 2007 May;29(5):537-43. doi: 10.1002/uog.4001.
To compare the diagnostic accuracy of two-dimensional (2D) ultrasound and three-dimensional (3D) computed tomography (CT) for the diagnosis of fetal skeletal anomalies.
Eleven pregnant women underwent 2D ultrasound and 3D-CT. Ten fetuses presented skeletal anomalies on 2D ultrasound and one fetus had a normal ultrasound exam but a familial history of osteopetrosis. We compared retrospectively the diagnoses established on 2D ultrasound and 3D-CT with the neonatal and/or postmortem work-up, which were used as the gold standard.
2D ultrasound provided the correct diagnosis in only two of the 11 cases. CT yielded the correct diagnosis in eight; in six of these, 2D ultrasound had been inconclusive. 3D-CT was more accurate than was 2D ultrasound in visualizing vertebral anomalies (abnormal shape of the vertebral bodies, abnormal interpedicular distance), pelvic bone malformations (delayed ossification of the pubic bones, abnormal acetabular shape) and enlarged metaphysis or synostoses in long bones. In three cases, neither 2D ultrasound nor CT provided the correct diagnosis.
In this series, which included a variety of skeletal dysplasias, 3D-CT had a better diagnostic yield than did 2D ultrasound. Both imaging techniques are useful in the management of fetal dysplasia; 2D ultrasound is a useful screening test and 3D-CT is a valuable complementary diagnostic tool.
比较二维（2D）超声和三维（3D）计算机断层扫描（CT）诊断胎儿骨骼异常的准确性。
11名孕妇接受了2D超声和3D-CT检查。10例胎儿在2D超声检查中表现出骨骼异常，1例胎儿超声检查正常，但有骨硬化症家族史。我们回顾性地比较了基于2D超声和3D-CT做出的诊断与作为金标准的新生儿和/或尸检结果。
11例病例中，2D超声仅在2例中做出了正确诊断。CT在8例中做出了正确诊断；其中6例，2D超声检查结果不明确。在观察椎体异常（椎体形状异常、椎弓根间距异常）、骨盆骨畸形（耻骨骨化延迟、髋臼形状异常）以及长骨干骺端增大或关节融合方面，3D-CT比2D超声更准确。3例中，2D超声和CT均未做出正确诊断。
在这个包括多种骨骼发育异常的系列研究中，3D-CT的诊断率优于2D超声。两种成像技术在胎儿发育异常的管理中都很有用；2D超声是一种有用的筛查方法，3D-CT是一种有价值的辅助诊断工具。
