Lan L M, Yamashita Y, Tang Y, Sugahara T, Takahashi M, Ohba T, Okamura H
Departments of Radiology, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860, Japan.
Radiology. 2000 Apr;215(1):205-10. doi: 10.1148/radiology.215.1.r00ap05205.
To analyze normal maturation of the fetal brain with half-Fourier rapid acquisition with relaxation enhancement (RARE) magnetic resonance (MR) imaging.
The normal brains of 25 fetuses of 12-38 weeks gestational age were examined in utero with half-Fourier RARE imaging. Gyrus maturation, gray and white matter differentiation, ventricle-to-brain diameter ratio, and subarachnoid space size were evaluated with respect to gestational age.
At 12-23 weeks, the brain had a smooth surface, and two or three layers were differentiated in the cerebral cortex. At 24-26 weeks, only a few shallow grooves were seen in the central sulcus, and three layers, including the immature cortex, intermediate zone, and germinal matrix, were differentiated in all fetuses. At 27-29 weeks, sulcus formation was observed in various regions of the brain parenchyma, and the germinal matrix became invisible. Sulcation was seen in the whole cerebral cortex from 30 weeks on. However, the cortex did not undergo infolding, and opercular formation was not seen before 33 weeks. At 23 weeks and earlier, the cerebral ventricles were large; thereafter, they gradually became smaller. The subarachnoid space overlying the cortical convexities was slightly dilated at all gestational ages, most markedly at 21-26 weeks.
Changes in brain maturation proceed through stages in an orderly and predictable fashion and can be evaluated reliably with half-Fourier RARE MR imaging.
采用半傅里叶采集单次激发快速自旋回波(RARE)磁共振成像分析胎儿脑的正常成熟过程。
对25例孕龄12 - 38周胎儿的正常脑进行宫内半傅里叶RARE成像检查。根据孕龄评估脑回成熟度、灰白质分化、脑室与脑直径比值及蛛网膜下腔大小。
12 - 23周时,脑表面光滑,大脑皮质分化为两层或三层。24 - 26周时,中央沟仅见少数浅沟,所有胎儿均分化出包括未成熟皮质、中间带和生发基质在内的三层结构。27 - 29周时,脑实质各区域出现沟回形成,生发基质不可见。30周起全脑皮质可见沟回,但皮质未发生内褶,33周前未见脑岛形成。23周及更早时,脑室较大;此后逐渐变小。各孕龄时皮质凸面上方的蛛网膜下腔均轻度扩张,21 - 26周时最为明显。
脑成熟变化按阶段有序且可预测地进行,半傅里叶RARE磁共振成像可可靠地评估这些变化。