Department of Radiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Magn Reson Imaging. 2021 Jun;53(6):1862-1870. doi: 10.1002/jmri.27519. Epub 2021 Feb 19.
Prenatal diagnosis and classification of hypospadias are difficult and of value for management during perinatal and neonatal periods. The conventional approach for prenatal diagnosis of hypospadias is ultrasound; however, this technique may be inconclusive in certain cases, which prompts for further exploration with magnetic resonance imaging (MRI).
To investigate the role of MRI in the prenatal diagnosis and classification of fetuses with hypospadias.
Retrospective.
Thirty-five fetuses (median gestational age = 37, range 24-39 weeks) with possible hypospadias.
FIELD STRENGTH/SEQUENCE: Single-shot fast spin echo T2-weighted imaging, fast imaging employing steady-state acquisition (FIESTA), and three-dimensional FIESTA acquired at 1.5 T.
Diagnosis and classification of hypospadias using MRI were performed by three experienced radiologists based on MRI features, including a short penile shaft, abnormal penile tip, penile curvature, bifid scrotum, "tulip sign," and penoscrotal transposition. The accuracy of MRI in the diagnosis and classification of hypospadias was assessed in comparison to postnatal clinical diagnosis. The interobserver agreement between radiologists was also assessed.
Kendall's W test was applied to assess the interobserver agreement between radiologists. Taking postnatal clinical diagnosis as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated.
Of the 35 fetuses, 24 cases were confirmed as hypospadias through postnatal clinical diagnosis. The interobserver agreement between radiologists was substantial (Kendall's W = 0.781, P < 0.001). Of the 24 confirmed cases (13 cases of severe hypospadias and 11 cases of mild hypospadias), 22 cases were correctly diagnosed by MRI. The accuracy of MRI in the diagnosis of hypospadias, severe hypospadias, and mild hypospadias was 85.71%, 82.86%, and 80.00%, respectively.
MRI has good performance in the diagnosis of fetal hypospadias. In addition, MRI could help evaluate the severity of fetal hypospadias.
3 TECHNICAL EFFICACY: Stage 2.
产前诊断和尿道下裂的分类具有挑战性，对于围产期和新生儿期的管理具有重要价值。产前诊断尿道下裂的常规方法是超声检查，但在某些情况下，该技术可能无法得出明确结论，因此需要进一步进行磁共振成像（MRI）检查。
探讨 MRI 在胎儿尿道下裂产前诊断和分类中的作用。
回顾性。
35 例（中位胎龄为 37 周，范围 24-39 周）可能患有尿道下裂的胎儿。
磁场强度/序列：单次激发快速自旋回波 T2 加权成像、稳态采集快速成像（FIESTA）和 1.5T 下采集的三维 FIESTA。
三位有经验的放射科医生根据 MRI 特征，包括短阴茎干、异常阴茎尖端、阴茎弯曲、分叉阴囊、“郁金香征”和阴茎阴囊转位，对尿道下裂进行 MRI 诊断和分类。将 MRI 诊断和分类的准确性与产后临床诊断进行比较。还评估了放射科医生之间的观察者间一致性。
Kendall's W 检验用于评估放射科医生之间的观察者间一致性。以产后临床诊断为参考标准，计算敏感性、特异性、阳性预测值、阴性预测值和准确性。
35 例胎儿中，24 例经产后临床诊断证实为尿道下裂。放射科医生之间的观察者间一致性较高（Kendall's W=0.781，P<0.001）。在 24 例确诊病例中（13 例严重尿道下裂和 11 例轻度尿道下裂），22 例病例的 MRI 诊断正确。MRI 对尿道下裂、严重尿道下裂和轻度尿道下裂的诊断准确性分别为 85.71%、82.86%和 80.00%。
MRI 在胎儿尿道下裂的诊断中具有良好的性能。此外，MRI 有助于评估胎儿尿道下裂的严重程度。
3 级技术功效：2 级。
