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Forebrain development in fetal MRI: evaluation of anatomical landmarks before gestational week 27

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Abstract

Introduction

Forebrain malformations include some of the most severe developmental anomalies and require early diagnosis. The proof of normal or abnormal prosencephalic development may have an influence on further management in the event of a suspected fetal malformation. The purpose of this retrospective study was to evaluate the detectability of anatomical landmarks of forebrain development using in vivo fetal magnetic resonance imaging (MRI) before gestational week (gw) 27.

Methods

MRI studies of 83 singleton fetuses (gw 16-26, average ± sd: gw 22 ± 2) performed at 1.5 Tesla were assessed. T2-weighted (w) fast spin echo, T1w gradient-echo and diffusion-weighted sequences were screened for the detectability of anatomical landmarks as listed below.

Results

The interhemispheric fissure, ocular bulbs, corpus callosum, infundibulum, chiasm, septum pellucidum (SP), profile, and palate were detectable in 95%, 95%, 89%, 87%, 82%, 81%, 78%, 78% of cases. Olfactory tracts were more easily delineated than bulbs and sulci (37% versus 18% and 8%), with significantly higher detection rates in the coronal plane. The pituitary gland could be detected on T1w images in 60% with an increasing diameter with gestational age (p = 0.041). The delineation of olfactory tracts (coronal plane), chiasm, SP and pituitary gland were significantly increased after week 21 (p < 0.05). Pathologies were found in 28% of cases.

Conclusion

This study provides detection rates for anatomical landmarks of forebrain development with fetal MRI before gw 27. Several anatomical structures are readily detectable with routine fetal MRI sequences; thus, if these landmarks are not delineable, it should raise the suspicion of a pathology. Recommendations regarding favorable sequences/planes are provided.

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Acknowledgments

The authors would like to thank the radiographer team of this institution for their commitment and skillfull work, Sheida Mehrain, M.D., for proofreading and Mary Mc. Alister for her help in editing the manuscript.

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology/Division of Neuro- and Musculoskeletal Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Maria T. Schmook, Michael Weber, Gregor Kasprian, Stefan Nemec & Daniela Prayer

  2. Integrative Morphology Group, Center for Anatomy and Cell Biology, Medical University of Vienna, Waehringer Strasse 13, 1090, Vienna, Austria

    Peter C. Brugger

  3. Department of Obstetrics and Gynecology / Division of Obstetrics and Feto-maternal Medicine, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Elisabeth Krampl-Bettelheim

Authors
  1. Maria T. Schmook
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  2. Peter C. Brugger
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  3. Michael Weber
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  4. Gregor Kasprian
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  5. Stefan Nemec
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  6. Elisabeth Krampl-Bettelheim
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  7. Daniela Prayer
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Correspondence to Maria T. Schmook.

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Schmook, M.T., Brugger, P.C., Weber, M. et al. Forebrain development in fetal MRI: evaluation of anatomical landmarks before gestational week 27. Neuroradiology 52, 495–504 (2010). https://doi.org/10.1007/s00234-010-0701-x

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  • DOI: https://doi.org/10.1007/s00234-010-0701-x

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