Comparative analysis of prenatal ultrasonography and fetal MRI of fetal spinal neural tube defects
Objective To compare the diagnostic accuracy and diagnostic advantages of prenatal ultrasound and fetal MRI for different types of fetal spinal neural tube defects(SNTDs),and to summarize the characteristic manifestations of prenatal ultrasound and fetal MRI for various types of SNTDs.Methods We prospectively followed up 161 fetuses admitted to the Neurosurgery Clinic of the First Medical Center of Chinese PLA General Hospital from July 2020 to February 2023 who were considered to have SNTDs in prenatal diagnosis and confirmed by spine MRI examination after birth.A retrospective review of their prenatal and postnatal imaging data was performed.Postnatal MRI examination results were taken as the diagnostic gold standard.The McNemar test was used to compare the diagnostic accuracy of prenatal ultrasound and fetal MRI for various types of fetal SNTDs.Results A total of 14 fetal SNTDs were included in the study.The diagnostic accuracy of prenatal ultrasound for spina bifida(P=0.001),intraspinal cyst(P=0.002)and dermal sinus(P=0.002)was higher than that of fetal MRI,while for intraspinal lipoma(P＜0.001)and lipomingocele(P=0.039),the diagnostic accuracy of prenatal ultrasound was lower than that of fetal MRI.Prenatal ultrasound was more accurate in diagnosing segmental spinal dysgenesis than fetal MRI(18/18 vs.7/18);fetal MRI was more accurate than prenatal ultrasound in diagnosing lipomyomeningocele(4/4 vs.3/4),sacrococcygeal hypoplasia(2/3 vs.0/3),syringomyelia(2/4 vs.0/4),caudal regression syndrome(1/1 vs.0/1),myelomeningocele(6/6 vs.3/6);for meningocele,tight filum terminale and sacrococcygeal teratoma,the diagnostic accuracy of prenatal ultrasound was the same as that of fetal MRI.For each type of fetal SNTDs,the manifestations of prenatal ultrasound and fetal MRI had their own characteristics.Conclusions Prenatal ultrasound and fetal MRI have different advantages in diagnosing fetal SNTDs.Fully understanding the characteristic prenatal imaging manifestations of SNTDs can improve the accuracy of prenatal diagnosis.
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