Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Ultrasound, Beijing Jishuitan Hospital, Beijing, China.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2192323. doi: 10.1080/14767058.2023.2192323.
This study aimed to analyze the ultrasound characteristics of fetal congenital vertical talus (CVT) to provide a detailed basis for the prenatal diagnosis of CVT.
We retrospectively analyzed the ultrasonographic findings of fetuses with CVT confirmed by X-ray, surgery, or autopsy from 2010 to 2020. Clinical characteristics and ultrasonographic findings of CVT, including foot morphology, ossification center of the calcaneus and talus, associated deformities, and chromosomal test results, were recorded.
Thirteen patients diagnosed with CVT by prenatal ultrasound were confirmed postpartum. Nine cases were bilateral, and four were unilateral. Under two-dimensional ultrasound, 13/13 cases had abnormal foot morphology, and 10 of 13 cases (76.9%) showed that the ossification center of the talus moved downward, and the calcaneus moved laterally. Under three-dimensional ultrasound, 11 cases (84.6%) presented a "rocking chair" appearance, and two cases did not obtain satisfactory three-dimensional image due to oligohydramnios and fetal position. In this group of cases, two cases (15.4%) were isolated CVT, and the other 11 cases (84.6%) were complicated with other abnormalities. Eleven cases of non-isolated CVT and 1 case of isolated CVT were induced, and another patient with isolated CVT had undergone postnatal surgery, which had been followed up for 8 years and recovered well.
The combination of fetal foot morphology, ossification center position of the calcaneus and talus, and three-dimensional ultrasound can provide a reliable diagnosis of CVT. Furthermore, we should pay more attention to the evaluation of other systemic and chromosomal abnormalities in CVT cases.
本研究旨在分析胎儿先天性垂直距骨（CVT）的超声特征，为 CVT 的产前诊断提供详细依据。
回顾性分析 2010 年至 2020 年经 X 线、手术或尸检证实的 CVT 胎儿的超声表现。记录 CVT 的临床特征和超声表现，包括足形态、跟骨和距骨的骨化中心、相关畸形以及染色体检查结果。
产前超声诊断为 CVT 的 13 例患者产后得到证实。9 例为双侧，4 例为单侧。二维超声下，13/13 例足部形态异常，13 例中有 10 例（76.9%）距骨骨化中心下移，跟骨向外侧移位。三维超声下，11 例（84.6%）呈“摇椅”样外观，2 例因羊水过少和胎儿体位不佳未能获得满意的三维图像。在这组病例中，2 例（15.4%）为单纯 CVT，其余 11 例（84.6%）合并其他异常。11 例非孤立性 CVT 中有 2 例（15.4%）为引产，另 1 例孤立性 CVT 患者接受了产后手术，术后随访 8 年，恢复良好。
胎儿足部形态、跟骨和距骨骨化中心位置以及三维超声相结合可以为 CVT 提供可靠的诊断。此外，我们应该更加注意 CVT 病例中其他系统性和染色体异常的评估。
