Sarkis Taifour MD, Presenter: Nothing to Disclose

Aygline Paternostre, Abstract Co-Author: Nothing to Disclose

Philippe Bouhanna, Abstract Co-Author: Nothing to Disclose

Brigitte Leroy, Abstract Co-Author: Nothing to Disclose

Joelle Roume MD, Abstract Co-Author: Nothing to Disclose

Marc David Molho MD, Abstract Co-Author: Nothing to Disclose

Jean Philippe Bault, Abstract Co-Author: Nothing to Disclose

Laurence Loeuillet, Abstract Co-Author: Nothing to Disclose

To evaluate the role of fetal low-dose multidetector computed tomography (MDCT) in the prenatal investigation of osteochondrodysplasia as a complementary imaging modality for optimal management of the patients.

Out of 168 cases in our archive we retrospectively analyzed the data of 80 patients who underwent prenatal low-dose MDCT with suspected skeletal abnormality on the 3D- and/or 2D-US examinations in order to evaluate this new technique which has replaced the antenatal radiography in our center. The fetuses were aged 30.4 weeks (from 19 to 39 weeks) with an average radiation dose of 5.1 mGy (CTDIw). The final diagnoses was established by neonatal (n=42) and/or post mortem (n=38) work-up and included achondroplasia (n=11), osteogenesis imperfecta (n=8), thanatophoric dysplasia (n=3), dysostoses (n=3), VACTERL association (n=2), intrauterine growth restriction (n=25), and single cases (n=25; Pfeiffer, Bartter, Treacher Collins, cleidocranial dysplasia, renal agenesis, and other). To assess the role of low-dose MDCT the following scoring system is used; noncontributory (score=0), confirming the diagnosis suspected by US (score=1), narrowing the differential diagnosis (score=2), reducing severity and/or eliminating association (score=3).

The fetal low-dose MDCT was not benefiting in 7 cases (score 0 = 8.75%), confirmed the suspected US diagnoses of skeletal dysplasia in 25 cases (score 1 = 31.25%), refined the differential diagnosis in 22 cases by adding new elements or morphologic finding (score 2 = 27.5%), and eliminated the severity and/or association in 26 cases (score 3 = 32.5%). The diagnostic accuracy of MDCT in osteogenesis imperfecta was 87.5% (7 out of 8 cases), where as the US accuracy was 50%, and 100% (11 out of 11 cases) in the achondroplasia with MDCT against 81.8% (9 out of 11). In the cases of suspected IUGR/achondrplasia on US (n=18) we eliminated the diagnosis of achondroplasia in 18 cases (100%).

The new technique of fetal low-dose MDCT is a valuable diagnostic methodology in the prenatal work-up of skeletal dysplasia.

The new technique of fetal low-dose MDCT can be a useful tool for the evaluation of osteochondrodysplasia in the assessment of osteochondrodysplasia especially in the third trimester.

Taifour, S, Paternostre, A, Bouhanna, P, Leroy, B, Roume, J, Molho, M, Bault, J, Loeuillet, L, Value of Fetal Low Dose MDCT in the Diagnosis of Skeletal Dysplasia in Multidisciplinary Work-up in France.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9003282.html