Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan.
Radiology, Tufts Medical Center, Boston, Massachusetts, USA.
Prenat Diagn. 2023 Oct;43(11):1450-1458. doi: 10.1002/pd.6436. Epub 2023 Sep 12.
To assess brain development in living fetuses with Down syndrome (DS) by biometric measurements on fetal brain magnetic resonance images (MRI).
We scanned 10 MRIs of fetuses with confirmed trisomy 21 at birth and 12 control fetal MRIs without any detected anomalies. Fetal brain MRIs were analyzed using 14 fetal brain and skull biometric parameters. We compared measures between DS and controls in both raw MRIs and motion-corrected and anterior-posterior commissure-aligned images.
In the reconstructed images, the measured values of the height of the cerebellar vermis (HV) and anteroposterior diameter of the cerebellar vermis (APDV) were significantly smaller, and the anteroposterior diameter of the fourth ventricle (APDF) was significantly larger in fetuses with DS than controls. In the raw MRIs, the measured values of the right lateral ventricle were significantly larger in fetuses with DS than in controls. Logistic regression analyses revealed that a new parameter, the cerebellar-to-fourth-ventricle ratio (i.e., (APDV * Height of the vermis)/APDF), was significantly smaller in fetuses with DS than controls and was the most predictive to distinguish between fetuses with DS and controls.
The study revealed that fetuses with DS have smaller cerebellums and larger fourth ventricles compared to the controls.
通过对唐氏综合征（DS）胎儿的胎儿磁共振成像（MRI）进行生物计量测量，评估其大脑发育情况。
我们对 10 例出生时被证实存在 21 三体的胎儿 MRI 进行了扫描，并对 12 例无任何异常发现的胎儿 MRI 进行了对照。使用 14 种胎儿脑和颅骨生物计量参数对胎儿脑 MRI 进行了分析。我们在原始 MRI 以及运动校正和前后连合对齐的图像中，对 DS 组和对照组的测量值进行了比较。
在重建图像中，DS 组胎儿的小脑蚓部高度（HV）和小脑蚓部前后径（APDV）的测量值明显较小，第四脑室前后径（APDF）明显较大。在原始 MRI 中，DS 组胎儿的右侧侧脑室测量值明显大于对照组。Logistic 回归分析显示，小脑与第四脑室的比值（即（APDV * 蚓部高度）/APDF）在 DS 组胎儿中明显小于对照组，是区分 DS 组和对照组的最具预测性的指标。
本研究表明，与对照组相比，DS 胎儿的小脑较小，第四脑室较大。
