Abstract
The fetal brain shows accelerated growth in the latter half of gestation, and these changes can be captured by 2D and 3D biometry measurements. The aim of this study was to quantify brain growth in normal fetuses using Magnetic Resonance Imaging (MRI) and to produce reference biometry data and a freely available centile calculator (https://www.developingbrain.co.uk/fetalcentiles/). A total of 127 MRI examinations (1.5 T) of fetuses with a normal brain appearance (21–38 gestational weeks) were included in this study. 2D and 3D biometric parameters were measured from slice-to-volume reconstructed images, including 3D measurements of supratentorial brain tissue, lateral ventricles, cortex, cerebellum and extra-cerebral CSF and 2D measurements of brain biparietal diameter and fronto-occipital length, skull biparietal diameter and occipitofrontal diameter, head circumference, transverse cerebellar diameter, extra-cerebral CSF, ventricular atrial diameter, and vermis height, width, and area. Centiles were constructed for each measurement. All participants were invited for developmental follow-up. All 2D and 3D measurements, except for atrial diameter, showed a significant positive correlation with gestational age. There was a sex effect on left and total lateral ventricular volumes and the degree of ventricular asymmetry. The 5th, 50th, and 95th centiles and a centile calculator were produced. Developmental follow-up was available for 73.1% of cases [mean chronological age 27.4 (±10.2) months]. We present normative reference charts for fetal brain MRI biometry at 21–38 gestational weeks. Developing growth trajectories will aid in the better understanding of normal fetal brain growth and subsequently of deviations from typical development in high-risk pregnancies or following premature delivery.
Highlights
The latter half of gestation (20–40 gestational weeks) is a dynamic period during which the human brain shows accelerated growth manifesting in increases in volume, cortical complexity and changes in the molecular and cellular composition of the different brain regions
We have not performed any correlations between MR measures and developmental scores as this is part of a separate study. This is the largest study to date, to the best of our knowledge, to produce 2D and 3D Magnetic Resonance Imaging (MRI) biometric reference data using 127 fetal brain images from normal fetuses ranging from 21.29 to 38.86 gestational weeks
The relative growth rates varied between structures with the cerebellum showing the fastest growth per week followed by the supratentorial brain tissue and the cortex, while the growth of the lateral ventricles was the slowest
Summary
The latter half of gestation (20–40 gestational weeks) is a dynamic period during which the human brain shows accelerated growth manifesting in increases in volume, cortical complexity and changes in the molecular and cellular composition of the different brain regions. While the use of MRI is becoming increasingly widespread, there is lack of a comprehensive high-quality MRI-based biometry data set of the normal fetus. Limitations have included the use of non-reconstructed data sets sensitive to fetal and maternal motion (Clouchoux et al 2011; Gong et al 1998; Grossman et al 2006), small gestational age range (Corbett-Detig et al 2011; Gholipour et al 2011; Gong et al 1998; Scott et al 2011), limited sample size (Corbett-Detig et al 2011; Gong et al 1998; Grossman et al 2006; Scott et al 2011), and inclusion of clinical cases (Gholipour et al 2011; Hu et al 2009). The aims of this study were to quantify fetal brain development in normal fetuses using MRI and to produce a freely available online centile calculator
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