Department of Radiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
Department of Imaging Center, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ann Med. 2021 Dec;53(1):1428-1437. doi: 10.1080/07853890.2021.1969590.
To provide the reference biometric measurements of the normal foetal brain by prenatal MRI and describe the distribution of measurements in the foetuses with ventricular septal defect (VSD).
This retrospective study analysed the biometric measurements of 218 foetuses between 18 - 37 gestational weeks with normal MRI findings from July 2014 to August 2019, as well as 18 foetuses with VSD. The measurements included fronto-occipital diameter (FOD), biparietal diameter (BPD), and transverse cerebellar diameter (TCD). All the prenatal MRI examinations have been taken on the same 1.5 T MR unit with a standard protocol of the foetal brain. All the linear measurements of the foetal brain were obtained on the T2-weighted imaging. The distribution of measurements in 18 foetuses with VSD was plotted on centile curves.
The reference data were presented in mean, standard deviation, 95% predicted confidence intervals, and the 3rd, 10th, 25th, 50th, 75th, 90th, 97th centiles at each gestational age. The value of TCD in 56% (10/18 cases) foetuses with VSD was lower than the 3rd centile, and the rate for FOD and BPD was 33% (6/18 cases) and 22% (4/18 cases) separately. On the curves, most VSD cases with measurements lower than the 3rd centile were in relatively early gestational stage (≤28 weeks).
We have presented reference linear biometry of the foetal brain by prenatal MRI from 18 to 37 gestational weeks, which could help us to interpret and monitor the brain development for foetuses with VSD and other congenital heart diseases.Key messages:We have presented reference linear biometry of the foetal brain by prenatal MRI from 18 to 37 gestational weeks in multiple statistical methods: mean and standard deviation; 95% predicted confidence intervals and the 3rd, 10th, 25th, 50th, 75th, 90th, 97th centiles.Our data showed that the involvement of the brain in VSD may be not globally, but regionally, and the cerebellum may be more possible to be involved.We speculated that the earlier the VSD diagnosed the worse the brain involved, which might suggest a poor outcome and necessary follow-up.
通过产前 MRI 为正常胎儿大脑提供参考生物测量值，并描述伴有室间隔缺损（VSD）的胎儿的测量值分布。
本回顾性研究分析了 2014 年 7 月至 2019 年 8 月期间 218 例 MRI 正常的 18-37 孕周胎儿以及 18 例 VSD 胎儿的生物测量值。测量包括额枕径（FOD）、双顶径（BPD）和横窦直径（TCD）。所有产前 MRI 检查均在同一台 1.5T MR 设备上进行，采用胎儿脑标准方案。所有胎儿脑的线性测量均在 T2 加权成像上获得。绘制了 18 例 VSD 胎儿的测量值分布在百分位曲线上。
参考数据以平均值、标准差、95%预测置信区间以及每个胎龄的第 3、第 10、第 25、第 50、第 75、第 90、第 97 百分位表示。在 56%（10/18 例）VSD 胎儿中，TCD 值低于第 3 百分位，FOD 和 BPD 值分别为 33%（6/18 例）和 22%（4/18 例）。在曲线上，大多数低于第 3 百分位的 VSD 病例处于相对较早的妊娠阶段（≤28 周）。
我们提出了 18-37 孕周胎儿产前 MRI 的线性脑生物测量参考值，有助于我们解释和监测 VSD 及其他先天性心脏病胎儿的脑发育。关键信息：我们提出了 18-37 孕周胎儿产前 MRI 的线性脑生物测量参考值，采用了多种统计方法：平均值和标准差；95%预测置信区间以及第 3、第 10、第 25、第 50、第 75、第 90、第 97 百分位。我们的数据表明，VSD 可能不是全局性的，而是区域性的，小脑可能更有可能受累。我们推测，VSD 诊断越早，脑受累越严重，可能预示着预后不良，需要随访。
