Department of Radiology, National Center for Child Health and Development, 2-10-1 Okura, Seatagaya-ku, Tokyo, 157-8535, Japan.
Pediatr Radiol. 2012 Jul;42(7):842-52. doi: 10.1007/s00247-012-2381-7. Epub 2012 Apr 25.
Clinical use of 3D CT for fetal skeletal malformations is controversial.
The purpose of this study was to evaluate the efficacy of fetal 3D CT using three protocols with different radiation doses and through comparing findings between fetal CT and conventional postnatal radiographic skeletal survey.
Seventeen fetuses underwent CT for suspected skeletal dysplasia. A relay of three CT protocols with stepwise dose-reduction were used over the study period. The concordance between the CT diagnosis and the final diagnosis was assessed. Ninety-three radiological findings identifiable on radiographs were compared with CT.
Fetal CT provided the correct diagnosis in all 17 fetuses, the detectability rate of cardinal findings was 93.5 %. In 59 % of the fetuses an US-based diagnosis was changed prenatally due to CT findings. The estimated fetal radiation dose in the final protocol was 3.4 mSv (50 %) of the initial protocol, and this dose reduction did not result in degraded image quality.
The capability of fetal CT to delineate the skeleton was almost the same as that of postnatal skeletal survey. The perinatal management was altered due to these more specific CT findings, which aided in counseling and in the management of the pregnancy.
临床应用 3D CT 检查胎儿骨骼畸形存在争议。
本研究旨在评估三种不同辐射剂量方案的胎儿 3D CT 的效能，并通过比较胎儿 CT 与常规产后放射性骨骼检查的结果来评估。
17 例胎儿因疑似骨骼发育不良而接受 CT 检查。在研究期间，采用了一系列逐步降低剂量的 CT 方案。评估 CT 诊断与最终诊断的一致性。比较了 93 例可在 X 线片上识别的放射学发现与 CT 的结果。
17 例胎儿的 CT 均提供了正确的诊断，主要发现的检出率为 93.5%。在 59%的胎儿中，由于 CT 结果，产前基于 US 的诊断发生了改变。最终方案的胎儿估计辐射剂量为初始方案的 3.4mSv（50%），这种剂量降低并未导致图像质量下降。
胎儿 CT 描绘骨骼的能力几乎与产后骨骼检查相同。由于这些更具体的 CT 发现，围产期管理发生了改变，这有助于咨询和妊娠管理。
