Fetal skeletal computed tomography: When? How? Why?

• Published in: Diagnostic and interventional imaging 2014-11, Vol.95 (11), p.1045-1053
• Main Authors: Gorincour, G, Chaumoitre, K, Bourliere-Najean, B, Bretelle, F, Sigaudy, S, D’Ercole, C, Philip, N, Potier, A, Petit, P, Panuel, M
• Format: Article
• Language: English
• Subjects: 2D ultrasound; Abnormalities, Multiple - diagnostic imaging; Abnormalities, Multiple - embryology; Biological anthropology; Bone Diseases, Developmental - diagnostic imaging; Bone Diseases, Developmental - embryology; Cephalometry; Congenital Abnormalities - diagnostic imaging; Congenital Abnormalities - embryology; Constitutional bone diseases; Diagnosis, Differential; Dysostoses - diagnostic imaging; Dysostoses - embryology; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - embryology; Femur - abnormalities; Femur - diagnostic imaging; Fetus - diagnostic imaging; Humanities and Social Sciences; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Infant, Newborn; Life Sciences; Pregnancy; Prenatal diagnosis; Prenatal Diagnosis - methods; Radiology; Tomography, X-Ray Computed - methods; Ultrasonography, Prenatal - methods
• ISSN: 2211-5684; 2211-5684
• DOI: 10.1016/j.diii.2014.04.014

Abstract Purpose To study the additional role of fetal skeletal computed tomography in suspected prenatal bone abnormalities. Materials and methods Two centers included in a retrospective study all fetuses who benefited from skeletal computed tomography for a suspected constitutional bone disease or focal dysostosis. Results A total of 198 patients were included. CT was performed in 112 patients (56%) for an isolated short femur below the third percentile (group A), in 15 patients (8%) for bowed or fractured femur (group B), in 23 patients (12%) for biometric discrepancy between a short femur and increased head circumference (group C) and in 48 patients (24%) for suspected focal dysostosis (group D). CT was interpreted as normal in 126 cases (64%), i.e. 87% in group A, 0% in group B, 65% in group C and 25% in group D. When including only cases with postnatal or postmortem clinical and/or radiological confirmation was available, CT provided additional and/or more accurate information than ultrasound in 20% of cases in group A, 66% in group B, 30% in group C and 72% in group D. Sixty-seven percent of patients in whom CT was interpreted as normal were lost to follow-up. Conclusion In isolated short femur, fetal skeletal CT is normal in the great majority of cases although protocolized follow-up of these babies is absolutely compulsory, as a large proportion is lost to follow-up. Fetal skeletal CT can confirm or improve imaging for the suspected diagnosis in suspected focal dysostosis or constitutional bone disease.