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Fetal Skeletal Dysplasia: Three-dimensional US-Initial Experience¹

¹ From the Department of Radiology, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093-0610 (K.V.G., D.H.P., N.E.B., T.R.N.); the Department of Obstetrics and Gynecology, University of Nevada, Las Vegas (C.J.C.); and the Division of Maternal-Fetal Medicine, Medical University of South Carolina, Charleston (D.D.J.). From the 1998 RSNA scientific assembly. Received August 20, 1998; revision requested October 23; final revision received June 28, 1999; accepted August 2. Supported in part by Medison America through an equipment loan and with financial support for research and education. Address reprint requests to D.H.P. (e-mail: dpretorius@ucsd.edu).

PURPOSE: To compare the prenatal ultrasonographic (US) features of skeletal dysplasia by using two-dimensional (2D) and three-dimensional (3D) US to determine whether 3D US can reveal additional diagnostic information.

MATERIALS AND METHODS: Seven pregnant women suspected of having skeletal dysplasia were examined by using 2D US and 3D US. Data regarding the thorax, spine, face, limbs, hands, and feet were compared. Multiplanar and volume-rendered US images were evaluated.

RESULTS: The skeletal dysplasias studied included camptomelic dysplasia (n = 2), thanatophoric dysplasia (n = 1), osteogenesis imperfecta (n = 1), arthrogryposis (n = 2), and short-limbed dysplasia (n = 1). Three-dimensional US, by allowing review in a standard anatomic orientation, was better than 2D US in depicting abnormal spatial relationships such as short ribs, splayed digits, and absent bones. Three-dimensional US enabled the acquisition of additional information in two fetuses with facial abnormalities and in two fetuses with scapular aplasia or hypoplasia (one fetus had both facial and scapular anomalies); it enabled a specific diagnosis in one fetus. The archiving capabilities of 3D US allow the review and manipulation of data after the patient has left the clinic.

CONCLUSION: In three of seven patients, 3D US provided additional information in the evaluation of skeletal dysplasias, as compared with 2D US.

Index terms: Fetus, abnormalities, 856.8713, 856.8732, 856.8733, • Fetus, skeletal system • Fetus, US, 856.12981, 856.12989 • Ultrasound (US), maximum intensity projection, 856.12989 • Ultrasound (US), three-dimensional, 856.12981, 856.12989

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