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普通X线摄影在日常实践中评估流产胎儿肌肉骨骼异常的作用。

The Role of Plain Radiography in Assessing Aborted Foetal Musculoskeletal Anomalies in Everyday Practice.

作者信息

Rossini Benedetta, Carnevale Aldo, Parenti Gian Carlo, Zago Silvia, Sigolo Guendalina, Feletti Francesco

机构信息

Unit of Radiology, S. Maria delle Croci Hospital, Ausl Romagna, 48121 Ravenna, Italy.

Dipartimento di Medicina Traslazionale e per la Romagna, Università degli Studi di Ferrara, 44121 Ferrara, Italy.

出版信息

J Imaging. 2024 Sep 27;10(10):242. doi: 10.3390/jimaging10100242.

DOI:10.3390/jimaging10100242
PMID:39452405
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11508908/
Abstract

Conventional radiography is widely used for postmortem foetal imaging, but its role in diagnosing congenital anomalies is debated. This study aimed to assess the effectiveness of X-rays in detecting skeletal abnormalities and guiding genetic analysis and counselling. This is a retrospective analysis of all post-abortion diagnostic imaging studies conducted at a centre serving a population of over 300,000 inhabitants from 2008 to 2023. The data were analysed using descriptive statistics. X-rays of 81 aborted foetuses (total of 308 projections; mean: 3.8 projections/examination; SD: 1.79) were included. We detected 137 skeletal anomalies. In seven cases (12.7%), skeletal anomalies identified through radiology were missed by prenatal sonography. The autopsy confirmed radiological data in all cases except for two radiological false positives. Additionally, radiology failed to identify a case of syndactyly, which was revealed by anatomopathology. X-ray is crucial for accurately classifying skeletal abnormalities, determining the causes of spontaneous abortion, and guiding the request for genetic counselling. Formal training for both technicians and radiologists, as well as multidisciplinary teamwork, is necessary to perform X-ray examinations on aborted foetuses and interpret the results effectively.

摘要

传统放射成像广泛用于死产胎儿成像,但其在诊断先天性异常中的作用存在争议。本研究旨在评估X射线在检测骨骼异常以及指导基因分析和咨询方面的有效性。这是一项对2008年至2023年在一个为超过30万居民服务的中心进行的所有流产后诊断成像研究的回顾性分析。数据采用描述性统计进行分析。纳入了81例流产胎儿的X射线检查(共308个投照;平均:3.8个投照/检查;标准差:1.79)。我们检测到137例骨骼异常。在7例(12.7%)中,产前超声检查漏诊了通过放射学检查发现的骨骼异常。除了2例假阳性放射学结果外,尸检证实了所有病例的放射学数据。此外,放射学检查未能识别出1例并指畸形,该病例由解剖病理学检查发现。X射线对于准确分类骨骼异常、确定自然流产原因以及指导基因咨询申请至关重要。对技术人员和放射科医生进行正规培训以及开展多学科团队合作,对于对流产胎儿进行X射线检查并有效解读结果而言是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/75036252bfe3/jimaging-10-00242-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/a74e2a143cb8/jimaging-10-00242-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/77b81105965d/jimaging-10-00242-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/0afa7aba68f9/jimaging-10-00242-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/75036252bfe3/jimaging-10-00242-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/a74e2a143cb8/jimaging-10-00242-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/77b81105965d/jimaging-10-00242-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/0afa7aba68f9/jimaging-10-00242-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67a1/11508908/75036252bfe3/jimaging-10-00242-g004.jpg

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本文引用的文献

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Combined prenatal US and post-mortem fetal MRI: can they replace conventional autopsy for fetal body abnormalities?产前超声联合胎儿 MRI 检查:能否替代传统尸检诊断胎儿体表异常?
Eur Radiol. 2024 Jan;34(1):632-642. doi: 10.1007/s00330-023-09847-y. Epub 2023 Aug 1.
2
Current utilization of pediatric postmortem imaging in North America: a questionnaire-based survey.北美地区儿科尸检后影像学的应用现状:一项基于问卷调查的研究。
Pediatr Radiol. 2023 May;53(6):1135-1143. doi: 10.1007/s00247-023-05586-w. Epub 2023 Feb 2.
3
The Practicality of Post-mortem Imaging in Prenatal, Perinatal, and Pediatric Cases.
尸检成像在产前、围产期和儿科病例中的实用性
Cureus. 2022 Sep 6;14(9):e28859. doi: 10.7759/cureus.28859. eCollection 2022 Sep.
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Current and future funding streams for paediatric postmortem imaging: European Society of Paediatric Radiology survey results.儿科尸检后影像学的当前和未来资金来源:欧洲儿科放射学会调查结果。
Pediatr Radiol. 2023 Feb;53(2):273-281. doi: 10.1007/s00247-022-05485-6. Epub 2022 Sep 13.
5
Post-mortem perinatal imaging: what is the evidence?围产期尸检影像学:证据有哪些?
Br J Radiol. 2023 Jul;96(1147):20211078. doi: 10.1259/bjr.20211078. Epub 2022 May 5.
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A pragmatic evidence-based approach to post-mortem perinatal imaging.一种基于证据的实用围产期尸检成像方法。
Insights Imaging. 2021 Jul 15;12(1):101. doi: 10.1186/s13244-021-01042-1.
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Consensus based recommendations for diagnosis and medical management of Poland syndrome (sequence).波兰综合征(序列)诊断和医学管理的共识建议。
Orphanet J Rare Dis. 2020 Aug 5;15(1):201. doi: 10.1186/s13023-020-01481-x.
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Exploring copy number variants in deceased fetuses and neonates with abnormal vertebral patterns and cervical ribs.探讨具有异常椎体形态和颈肋的死亡胎儿和新生儿中的拷贝数变异。
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Diagnostic accuracy of postmortem ultrasound vs postmortem 1.5-T MRI for non-invasive perinatal autopsy.死后超声与 1.5-T 磁共振成像在非侵入性围产儿尸检中的诊断准确性。
Ultrasound Obstet Gynecol. 2021 Mar;57(3):449-458. doi: 10.1002/uog.22012.
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