Article Figures & Data
Figures
- Fig 1.
A 22-week fetus with normal cerebral lamination. A, On a T1-weighted image, the germinal matrix is of high T1 signal intensity, the intermediate zone is of slightly lower T1 signal intensity relative to the subplate layer, and the cortex is of high T1 signal intensity. B, On a T2-weighted image, the germinal matrix is of low T2 signal intensity, the intermediate zone is of lower T2 signal intensity relative to the subplate layer, and the cortex is of lower T2 signal intensity compared with subplate layer.
- Fig 2.
A 22-week fetus with neuroaxonal dystrophy. A, Coronal T1-weighted image shows disruption of normal cerebral lamination, with loss of distinction between the cortex and subplate layer (asterisk), and the high T1 signal intensity of the germinal matrix is not visualized. B, Coronal T2-weighted image shows the presence of normal distinct cerebral lamination. The abnormal cerebral lamination is detected on the T1-weighted image (A) but not on the T2-weighted image (B). The sulcation and gyration of the cerebral hemispheres are abnormal. C and D, Gross pathology section of the cerebrum (C) and whole mount histology (D) stain (hematoxylin-eosin, 1× magnification) show the presence of attenuated lamination in the cerebral mantle. The temporal horns are dilated with a thinned temporal cortex (black arrow).
- Fig 3.
A 29-week fetus with neuronal migration disorder. A −D, Coronal T1- (A and B) and T2-weighted (C and D) images show disruption of the normal cerebral lamination, and the cortical layer appears thickened. There is gray matter heterotopia within the left cerebral mantle (small arrow). The sulcation and gyration are abnormal, and there is also agenesis of the corpus callosum. E−H, Whole mount (E and F) stain (hematoxylin-eosin, 1× magnification) and gross pathology (G and H) sections of the brain illustrate agenesis of the corpus callosum and caudate nuclei as well as focal infarcts as indicated by asterisks. There are absence of the normal cerebral lamination and a focal area of deranged cortical architecture within the cerebral mantle (black arrow).
- Fig 4.
A 22-week fetus with neuronal migration disorder. Coronal T1- (A) and T2-weighted (B) images demonstrate an attenuated cortex, subplate layer, and intermediate zone on the medial aspect of the left frontal lobe, associated with focal deepening of the sulcus at the same site (arrowhead). C, Gross pathology section of the cerebrum demonstrates a deep sulcus on the medial aspect of the left frontal lobe. D, Histology stain (hematoxylin-eosin, 50× magnification) shows dysplastic hypocellular cortex noted at the site of an abnormally deep sulcus and the overlying arachnoid contains a cyst lined by a single layer of choroid plexus−type epithelium (arrow). There is also agenesis of the corpus callosum.
- Fig 5.
A, 25-week fetus with hypoxic-ischemic injury. Coronal T1- (A) and T2-weighted (B) images demonstrate patchy areas of increased T1 and reduced T2 signal intensity (small arrows) within the subplate layer and intermediate zone. The sulcation and gyration pattern is normal. C, Histology stain (hematoxylin-eosin) demonstrates normal cerebral lamination that is age-appropriate. D, Microscopy (630× magnification) demonstrates karyorrhectic neurons (large arrow) in brain stem nuclei, likely due to hypoxic-ischemic injury.
Tables
- Table 1:
Agreement between T1- and T2-weighted postmortem MRI assessment of germinal matrix, intermediate zone, subplate layer, cortex, and overall cerebral lamination and histology
T1-Weighted Images T2-Weighted Images Abnormal Normal Abnormal Normal Germinal matrix 20/25 29/30 19/25 30/30 Intermediate zone 23/26 26/29 18/26 28/29 Subplate layer 22/26 27/29 18/26 28/29 Cortex 21/26 29/29 15/26 29/29 Overall cerebral lamination 25/26 26/29 19/26 28/29 - Table 2:
Sensitivity, specificity, and positive and negative predictive values of the germinal matrix, intermediate zone, subplate layer, and cortex on T1-weighted postmortem MRI
Sensitivity Specificity PPV NPV T1 germinal matrix 80.00% 96.67% 95.24% 85.29% (CI, 58.70%–92.39%) (CI, 80.95%–99.83%) (CI, 74.13%–99.75%) (CI, 68.17%–94.46%) T1 intermediate zone 88.46% 89.66% 88.00% 89.66% (CI, 68.72%–96.97%) (CI, 71.50%–97.29%) (CI, 68.72%–96.97%) (CI, 71.50%–97.29%) T1 subplate layer 84.62% 93.10% 91.67% 87.10% (CI, 64.27%–94.95%) (CI, 75.79%–98.80%) (CI, 71.53%–98.54%) (CI, 69.24%–95.78%) T1 cortex 80.77% 100% 100% 85.29% (CI, 60.02%–92.69%) (CI, 85.44%–100%) (CI, 80.76%–100%) (CI, 68.17%–94.46%) T1 overall 96.15% 89.66% 89.29% 96.29% (CI, 78.42%–99.80%) (CI, 71.50%–97.29%) (CI, 70.63%–97.19%) (CI, 79.11%–99.80%) - Table 3:
Sensitivity, specificity, and positive and negative predictive values of the germinal matrix, intermediate zone, subplate layer, and cortex on T2-weighted postmortem MRI
Sensitivity Specificity PPV NPV T2 germinal matrix 76.00% 100% 100% 83.33% (CI, 54.48%–89.84%) (CI, 85.87%–100%) (CI, 79.08%–100%) (CI, 66.53%–93.04%) T2 intermediate zone 69.23% 96.55% 94.74% 77.78% (CI, 48.10%–4.91%) (CI, 80.37%–99.82%) (CI, 71.89%–99.72%) (CI, 60.41%–89.27%) T2 subplate layer 69.23% 96.55% 94.74% 77.78% (CI, 48.10%–84.91%) (CI, 80.37%–88.82%) (CI, 71.89%–99.72%) (CI, 60.41%–89.27%) T2 cortex 57.69% 100% 100% 72.50% (CI, 37.19%–76.03%) (CI, 85.44%–100%) (CI, 74.65%–100%) (CI, 55.86%–84.86%) T2 overall 73.08% 96.55% 95.00% 80.00% (CI, 51.95%–87.65%) (CI, 80.37%–99.82%) (CI, 73.06%–99.74%) (CI, 62.54%–90.94%)
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