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Normal development of sacrococcygeal centrum ossification centers in the fetal spine: a postmortem magnetic resonance imaging study

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

To describe the temporal pattern of the appearance of the S1–Co1 centrum ossification centers (COCs) and provide reference data for the S1–S5 COCs and sacral length at various gestational ages (GAs).

Methods

Postmortem magnetic resonance imaging (MRI) was performed on 71 fetuses (GA, 17–42 weeks) using the 3D dual-echo steady-state with water excitation T2 sequence in the sagittal plane. To confirm the reliability of this sequence, the MRI data were compared with the CT and histologic data obtained from two fetuses (GAs, 21 and 30 weeks). The presence or absence of each sacrococcygeal COC was recorded. Sacral length and S1–S5 COC height, sagittal diameter, transverse diameter, cross-sectional area, and volume were measured.

Results

All fetuses showed S1–S3 COCs by 17 weeks, S4 COCs by 19 weeks, and S5 COCs by 28 weeks. The S4, S5, and Co-1 COCs were visualized in 70 (98.59%), 51 (71.83%), and 21 (29.58%) fetuses, respectively. Sacral length, height, sagittal, and transverse diameters increased linearly, while cross-sectional area and volume increased exponentially with advancing GA. Mean growth rates of the sagittal and transverse diameters, cross-sectional area, and volume, but not of height, significantly differed among the S1–S5 vertebrae.

Conclusion

We have presented the timing of appearance of individual sacrococcygeal COCs and the age-specific, normative MRI reference values for sacral length and the morphometric parameters of the sacral COCs, which are of clinical importance in the diagnosis of congenital sacral abnormalities and skeletal dysplasia.

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Abbreviations

GA:

Gestational age

3D DESS with WE:

Three-dimensional dual-echo steady-state with water excitation

COC:

Centrum ossification center

NAOC:

Neural arch ossification center

LS mean:

Least-squares mean

LSMD:

Least-squares mean difference

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Funding

This study was funded by the National Natural Science Foundation of China (Project Code: 31371213) and the Natural Science Foundation of Shandong Province, China (Project Code: ZR2013HM091).

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Authors and Affiliations

  1. Shandong Medical Imaging Research Institute, Shandong University, No. 44 West Wenhua Road, Jinan, 250012, Shandong, China

    Nan Jian, Mi-Mi Tian, Lian-Xiang Xiao, Yan Shi, Shuai Zhang & Xiang-Tao Lin

  2. CT Department, Heze Municipal Hospital, No. 2888 West Caozhou Road, Heze, 274031, Shandong, China

    Nan Jian

  3. Department of Imaging, Shandong Provincial Hospital Affiliated to Shandong University, No. 324 Jingwu Road, Jinan, 250021, Shandong, China

    Hui Zhao

  4. College of Radiology, Taishan Medical University, NO.619 Great Wall Road, Taian, 271016, Shandong, China

    Guan Li

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  1. Nan Jian
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Correspondence to Xiang-Tao Lin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Shandong University Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

Electronic supplementary materials

Fig. S1

Regression lines for the (a) height, (b) sagittal diameter, (c) transverse diameter, (d) cross-sectional area, and (e) volume of the S1 centrum ossification center (PNG 596 kb)

High-resolution image (TIF 767 kb)

Fig. S2

Regression lines for the (a) height, (b) sagittal diameter, (c) transverse diameter, (d) cross-sectional area, and (e) volume of the S2 centrum ossification center (PNG 611 kb)

High-resolution image (TIF 772 kb)

Fig. S3

Regression lines for the (a) height, (b) sagittal diameter, (c) transverse diameter, (d) cross-sectional area, and (e) volume of the S3 centrum ossification center (PNG 623 kb)

High-resolution image (TIF 787 kb)

Fig. S4

Regression lines for the (a) height, (b) sagittal diameter, (c) transverse diameter, (d) cross-sectional area, and (e) volume of the S4 centrum ossification center (PNG 573 kb)

High-resolution image (TIF 754 kb)

Fig. S5

Regression lines for the (a) height, (b) sagittal diameter, (c) transverse diameter, (d) cross-sectional area, and (e) volume of the S5 centrum ossification center (PNG 581 kb)

High-resolution image (TIF 741 kb)

Supplementary Table 1

Mean height, sagittal diameter, transverse diameter, cross-sectional area, and volume of individual sacral vertebral level (S1 to S5) (DOCX 15 kb)

Supplementary Table 2

Estimated least-squares means for sexes (males and females) and individual sacral vertebral level (S1 to S5) for height, sagittal diameter, transverse diameter, cross-sectional area, and volume (DOCX 16 kb)

Supplementary Table 3

Pairwise comparison between males and females, and Multiple pairwise comparisons among the S1–S5 vertebrae for height, sagittal diameter, transverse diameter, cross-sectional area, and volume (DOCX 18 kb)

Supplementary Table 4

Fixed-effect coefficients of the linear mixed model with the S1–S5 height, sagittal diameter, transverse diameter, cross-sectional area, and volume as dependent variables and vertebral level, gestational age, sex, gestational age and sex interaction effect, as well as gestational age and vertebral level interaction effect as independent variables (DOCX 18 kb)

Supplementary Table 5

Functions of S1–S5 height, sagittal diameter, transverse diameter, cross-sectional area, and volume (DOCX 16 kb)

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Jian, N., Tian, MM., Xiao, LX. et al. Normal development of sacrococcygeal centrum ossification centers in the fetal spine: a postmortem magnetic resonance imaging study. Neuroradiology 60, 821–833 (2018). https://doi.org/10.1007/s00234-018-2050-0

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  • DOI: https://doi.org/10.1007/s00234-018-2050-0

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