Cortical maturation in normal and abnormal fetuses as assessed with prenatal MR imaging.
OBJECTIVE
To establish the appearance of normal fetal cortical development in utero and compare it with the appearance of abnormal cortical development.


METHODS
Magnetic resonance (MR) images of the brain in 53 normal and 40 abnormal fetuses at 14-38 weeks gestational age (GA) were reviewed. The GAs at the time of MR imaging visualization of the fissures or sulci were compared with the GA guidelines based on neuroanatomic studies.


RESULTS
In normal fetuses, the sulcation landmarks appeared on MR images in the order predicted by using anatomic studies, with a 0-8-week lag in the MR imaging visualization of the sulci compared with the reported time of visualization of the sulci in anatomic specimens. When landmarks were grouped by range of GAs, the expected MR imaging sulcation landmarks in the group with younger GAs than the actual GA were seen in 50 of 53 (94%) normal fetuses, in five of nine fetuses (56%, P < .05) with isolated mild ventriculomegaly, and in 24 of 31 fetuses (77%, P < .05) with other CNS anomalies.


CONCLUSIONS
Normal fetal cortical maturation at MR imaging follows a predictable course that is slightly delayed compared with that described in neuroanatomic specimens. This maturation is often further delayed in fetuses with CNS abnormalities.
Levine
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Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Barnes
P D
PD
D061085:Agenesis of Corpus Callosum; D001921:Brain / Q000002:abnormalities / Q000196:embryology*; D001927:Brain Diseases / Q000196:embryology; D002540:Cerebral Cortex / Q000002:abnormalities / Q000196:embryology; D002552:Cerebral Ventricles / Q000002:abnormalities / Q000196:embryology; D003337:Corpus Callosum / Q000196:embryology; D004200:Diseases in Twins / Q000196:embryology; D005314:Embryonic and Fetal Development; D004677:Encephalocele / Q000196:embryology; D005260:Female; D005500:Follow-Up Studies; D005583:Fourier Analysis; D005865:Gestational Age; D006179:Gyrus Cinguli / Q000002:abnormalities / Q000196:embryology; D016142:Holoprosencephaly / Q000196:embryology; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis