Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Pediatr Radiol. 2010 Dec;40(12):1874-9. doi: 10.1007/s00247-010-1708-5. Epub 2010 May 20.
The sensitivity and specificity of evaluating clubfoot deformity by MR in high-risk fetuses is currently unknown.
To correlate fetal MRI with US in the assessment of clubfoot and to identify the MRI features most characteristic of clubfoot.
With IRB approval and informed consent, the presence of fetal clubfoot was prospectively evaluated in mothers referred for MRI for a fetus with myelomeningocele. Two radiologists blind to the US results independently reviewed the MRI for the presence of clubfoot. MRI results were compared with US results obtained the same day and birth outcomes.
Of 20 patients enrolled, there were 13 clubfeet. Interobserver agreement for the presence of clubfoot was 100%. The sensitivity of the MRI exam was 100% and the specificity 85.2%. A dedicated sagittal imaging plane through the ankle region allowed the most confident diagnosis; medial deviation of the foot relative to the leg was seen in all 13 fetuses with clubfoot.
The correlation of fetal MRI with US in the evaluation of clubfoot yields a sensitivity of 100% and specificity of 85.2%. The sagittal plane provided the most useful information.
目前尚不清楚通过 MRI 评估高危胎儿马蹄内翻足畸形的敏感性和特异性。
将胎儿 MRI 与 US 评估马蹄内翻足进行相关性分析，并确定最具马蹄内翻足特征的 MRI 特征。
经机构审查委员会批准和知情同意，前瞻性评估了因脊髓脊膜膨出而行 MRI 检查的胎儿中是否存在胎儿马蹄内翻足。两名对 US 结果不知情的放射科医生独立评估 MRI 中是否存在马蹄内翻足。将 MRI 结果与同日获得的 US 结果和出生结局进行比较。
在 20 名入组患者中，有 13 例出现马蹄内翻足。存在马蹄内翻足的观察者间一致性为 100%。MRI 检查的敏感性为 100%，特异性为 85.2%。通过踝关节区域的专用矢状成像平面可做出最有信心的诊断；在所有 13 例患有马蹄内翻足的胎儿中，均可见足部相对于腿部的内侧偏斜。
胎儿 MRI 与 US 评估马蹄内翻足的相关性分析得出的敏感性为 100%，特异性为 85.2%。矢状面提供了最有用的信息。
