Zhao Yijun,Wang Zhan,He Jing,et al.Diagnostic accuracy of prenatal imaging for fetal hypospadias[J].Journal of Clinical Pediatric Surgery,,22():719-725.[doi:10.3760/cma.j.cn101785-202306020-004]
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Diagnostic accuracy of prenatal imaging for fetal hypospadias

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第22卷 Number: 2023 08 Page: 719-725 Column: 专题·出生缺陷产前产后一体化诊治 Date of publication: 2023-08-28
Author(s):
Zhao Yijun1;  Wang Zhan1;  He Jing2;  Wang Zhengping2;  Wang Junmei3;  Lou Fenlan4;  Dong Minyue5;  Tang Daxing1
1. Department of Urology, Affiliated Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children’s Health, National Regional Medical Center, Hangzhou 310052, China;
2. Department of Obstetrics, Affiliated Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China;
3. Department of Ultrasonic Diagnosis, Affiliated Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China;
4. Department of Radiology, Affiliated Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China;
5. Department of Reproductive Genetics, Affiliated Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
Keywords:
Fetus; Hypospadias; Ultrasonography;  Prenatal; Magnetic Resonance Imaging; Prenatal Diagnosis
DOI:
10.3760/cma.j.cn101785-202306020-004
Abstract:
Objective To explore the diagnostic accuracy of prenatal imaging (prenatal ultrasound & fetal magnetic resonance imaging) for fetal hypospadias.Methods Retrospective review was conducted for 31 pregnant women with prenatally diagnosed hypospadias through multidisciplinary consultations at Zhejiang Prenatal Diagnosis Center from March 2012 to March 2021, including age, gestational week, ultrasound and fetal MRI images.Results Thirty-one pregnant women were diagnosed with fetal hypospadias by prenatal ultrasound with an average age of (29.8±4.4) years and an average gestational week of (30.1±3.2) weeks, including 4 cases in the second trimester and 27 cases in the third trimester.Among them, 22 cases of hypospadias were confirmed postnatally with a diagnostic accuracy of 71.0%.The major ultrasonographic features included ‘tulip sign’ of external genitalia (n=19, 61.3%), short external genitalia (n=4, 12.9%) and ambiguous external genitalia (n=8, 25.8%).The diagnostic accuracy of ‘tulip sign’ for fetal hypospadias was 84.2%(16/19) with a sensitivity of 72.7% and a specificity of 66.7%.Fetal MRI was performed in 15 cases.Major MRI features included short external genitalia (n=10), ‘tulip sign’ of external genitalia (n=6), bifid scrotum (n=4), blunt penile tip (n=3), penile curvature (n=2), penoscrotal transposition (n=1) and gender identification (female, n=1).The accuracy of fetal MRI in prenatal diagnosis of hypospadias was 85.7% (12/14).Result of amniocentesis hinted at 46, XY and androgen insensitivity syndrome.It was confirmed as severe hypospadias after induced labor.Conclusion Ultrasonography is the most common diagnostic procedure for fetal hypospadias.And ‘tulip sign’ is commonly present with a high accuracy.Fetal MRI may boost the accuracy of prenatal diagnosis when prenatal hypospadias is suspected by ultrasonography.

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Memo

收稿日期:2023-06-12。
通讯作者:唐达星,Email:tangdx0206@zju.edu.cn

Last Update: 1900-01-01