Corroboration of Normal and Abnormal Fetal Cerebral Lamination on Postmortem MR Imaging with Postmortem Examination

• Published in: American journal of neuroradiology : AJNR 2010-11, Vol.31 (10), p.1987-1993
• Main Authors: WIDJAJA, E, GEIBPRASERT, S, ZAREI MAHMOODABADI, S, BROWN, N. E, SHANNON, P
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Brain Diseases - pathology; Cerebral Cortex - abnormalities; Cerebral Cortex - embryology; Cerebral Cortex - pathology; Diagnosis; Fetal Death; Fundamental and applied biological sciences. Psychology; Gestational Age; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Multimodal perception; Nervous system; Pediatrics; Perception; Predictive Value of Tests; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A2193

The presence of normal fetal cerebral lamination of the germinal matrix, intermediate zone, subplate layer, and cortex can be used as a marker of normal fetal cerebral development. Our aim was to compare postmortem MR imaging assessment of normal and abnormal fetal cerebral lamination on T1- and T2-weighted images with histopathology. Fifty-five formalin-fixed brains from postmortem fetuses, ranging from 16 to 30 weeks' gestational age, mean of 23 weeks, underwent T1- and T2- weighted MR imaging and subsequent sectioning and histologic examination. The cerebral lamination was graded as normal or abnormal on T1- and T2-weighted imaging and compared with postmortem findings. The sensitivity, specificity, and positive and negative predictive values of T1 and T2 assessment of cerebral lamination were calculated. Twenty-six fetuses had abnormal and 29 had normal cerebral lamination on histology. On T1, the overall sensitivity, specificity, and positive and negative predictive values of evaluating cerebral lamination were 96.15%(CI, 78.42%-99.80%), 89.66%(CI, 71.50%-97.29%), 89.29%(CI, 70.63%-97.19%), and 96.29%(CI, 79.11%-99.80%), respectively. On T2, the overall sensitivity, specificity, and positive and negative predictive values of evaluating cerebral lamination were 73.08%(CI, 51.95%-87.65%), 96.55%(CI, 80.37%-99.82%), 95.00%(CI, 73.06%-99.74%), and 80.00%(CI, 62.54%-90.94%), respectively. Postmortem MR imaging has high sensitivity, specificity, and positive and negative predictive values in assessing fetal cerebral lamination compared with histology. T1-weighted imaging has a higher sensitivity and negative predictive value, while T2-weighted imaging has a higher specificity and positive predictive value.