Abstract
Background
Clinical use of 3D CT for fetal skeletal malformations is controversial.
Objective
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.
Materials and methods
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.
Results
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.
Conclusion
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.
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Acknowledgments
This article was supported by a grant for scientific research from the Ministry of Health, Labour and Welfare of Japan, H23-Nanchi-Ippan-123.
We thank CT technologists Fumie Okazaki, Ayano Shimada and Hiroshi Nagamatsu. We would like to thank pediatric radiologists at the National Center for Child Health and Development, Drs. Shunsuke Nosaka, Yoshiyuki Tsutsumi, Mikiko Miyasaka, and Reiko Okamoto.
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Miyazaki, O., Nishimura, G., Sago, H. et al. Prenatal diagnosis of fetal skeletal dysplasia with 3D CT. Pediatr Radiol 42, 842–852 (2012). https://doi.org/10.1007/s00247-012-2381-7
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DOI: https://doi.org/10.1007/s00247-012-2381-7