Prenatal diagnosis of hypospadias with 2-dimensional and 3-dimensional ultrasonography

Zhonglu Zhang,Xia An,Xiaohua Li,Aqing Liu,Shaochun Wang

doi:10.1038/s41598-019-45221-z

Zhonglu Zhang, Xia An + Show 3 more

Open Access

https://doi.org/10.1038/s41598-019-45221-z

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Abstract

To compare the prenatal diagnostic performance as well as appearance of ultrasonic details between 2-dimensional ultrasonography (2DUS) combined with 3-dimensional ultrasonography (3DUS) and 2DUS alone for hypospadias. A total of 47 fetuses were enrolled and examined by 2DUS and then 3DUS. Postnatal follow-up data were obtained and 28 cases were confirmed of hypospadias. Although not statistically significant, there was a trend toward higher AUC (0.85 vs. 0.76; p = 0.08), ACC (85.1 vs. 76.6%; p = 0.22), SEN (85.7 vs. 78.6%; p = 0.63), and SPE (84.2 vs. 73.7%; p = 0.50) for 2DUS combined with 3DUS compared with 2DUS alone. The agreement between both methods was moderate [kappa = 0.592]. Both modalities showed accurately the short penis and blunt tip of the penis. 2DUS in combination with 3DUS showed more cases in other detailed features, such as “chordee”, a “hooded” incomplete prepuce, and so on. Overall 2DUS combined with 3DUS showed a trend toward higher performance compared with 2DUS alone for the diagnosis of hypospadias, although the difference was not statistically significant. 3DUS is a useful complement for 2DUS in the diagnosis of fetal hypospadias and may provide more detailed information related to its diagnosis and prognosis.

Highlights

Hypospadias refers to urinary tract ectopic opening at any position along penile ventral to the perineum, the most common deformity for male genitalia, the incidence for live births is 0.2–4.1/10001
Physical examinations were performed by experienced pediatric surgeons on 42 newborns, and autopsies were performed on all 5 terminated fetuses to determine the presence or absence of hypospadias
There was a trend toward higher area under the ROC curve (AUC) (0.85 vs. 0.76%; p = 0.08), ACC (85.1 vs. 76.6%; p = 0.22), SEN (85.7 vs. 78.6%; p = 0.63), and SPE (84.2 vs. 73.7%; p = 0.50) for 2-dimensional ultrasonography (2DUS) combined with 3-dimensional ultrasonography (3DUS) compared with 2DUS alone

Summary

Introduction

Hypospadias refers to urinary tract ectopic opening at any position along penile ventral to the perineum, the most common deformity for male genitalia, the incidence for live births is 0.2–4.1/10001. Literatures have reported that 3-dimensional ultrasonography (3DUS) may show clearly the shape of the penis and the relationship between the penis and scrotum, contributing to prenatal diagnosis of fetal hypospadias[2,3,4,5]. Most of these were described in case reports, and as far as we know, no study has compared the diagnostic performance of fetal hypospadias between 2DUS and 3DUS. Receiver operating characteristic (ROC) curve analysis was performed, and we compare the area under the ROC curve (AUC), diagnostic accuracy (ACC), sensitivity (SEN), specificity (SPE), and detailed ultrasonic findings related to the diagnosis of hypospadias between 2DUS in combination with 3DUS and 2DUS alone

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