Normal human brainstem development in vivo: a quantitative fetal MRI study

• Published in: Ultrasound in obstetrics & gynecology 2021-08, Vol.58 (2), p.254-263
• Main Authors: Dovjak, G. O., Schmidbauer, V., Brugger, P. C., Gruber, G. M., Diogo, M., Glatter, S., Weber, M., Ulm, B., Prayer, D., Kasprian, G. J.
• Format: Article
• Language: English
• Subjects: Brain; Brain stem; Brain Stem - diagnostic imaging; Brain Stem - growth & development; brainstem; brainstem planimetry; Cerebellum; Correlation coefficient; Correlation coefficients; Diameters; Female; fetal MRI; Fetus - diagnostic imaging; Fetuses; Gestation; Gestational Age; Growth patterns; Gynecology; Hindbrain; hindbrain malformation; Humans; Image segmentation; In vivo methods and tests; Magnetic Resonance Imaging; Medulla oblongata; Mesencephalon; Morphology; MRI; neurodevelopment; Neuroimaging; Obstetrics; Original Paper; Original Papers; Pons; posterior fossa; Pregnancy; Prenatal Diagnosis; Reference Values; Retrospective Studies; Tegmentum; Ultrasonic imaging; Ultrasound
• ISSN: 0960-7692; 1469-0705
• DOI: 10.1002/uog.22162

ABSTRACT Objectives To characterize spatiotemporal growth differences of prenatal brainstem substructures and cerebellum, using linear biometry and planimetry on fetal magnetic resonance imaging (MRI). Methods In this retrospective study, we included fetuses with normal brain and a precise midsagittal T2‐weighted brain MRI sequence obtained between May 2003 and April 2019. The cross‐sectional area, rostrocaudal diameter and anteroposterior diameter of the midbrain, pons (basis pontis and pontine tegmentum), medulla oblongata and cerebellar vermis, as well as the transverse cerebellar diameter, were quantified by a single observer. The diameters were also assessed by a second observer to test inter‐rater variability. Results We included 161 fetuses with normal brain and a precise midsagittal MRI sequence, examined at a mean ± SD gestational age of 25.7 ± 5.4 (range, 14 + 0 to 39 + 2) weeks. All substructures of the fetal brainstem and the cerebellum could be measured consistently (mean ± SD interobserver intraclass correlation coefficient, 0.933 ± 0.065). We provide reference data for diameters and areas of the brainstem and cerebellum in the second and third trimesters. There was a significant quadratic relationship between vermian area and gestational age, and all other measured parameters showed a significant linear growth pattern within the observed period (P