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Research ArticlePediatric Neuroimaging

Prenatal Brain MR Imaging: Reference Linear Biometric Centiles between 20 and 24 Gestational Weeks

G. Conte, S. Milani, G. Palumbo, G. Talenti, S. Boito, M. Rustico, F. Triulzi, A. Righini, G. Izzo, C. Doneda, A. Zolin and C. Parazzini
American Journal of Neuroradiology May 2018, 39 (5) 963-967; DOI: https://doi.org/10.3174/ajnr.A5574
G. Conte
aFrom the Neuroradiology Unit (G.C.,G.P., F.T.)
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S. Milani
cDepartment of Clinical Sciences and Community Health (S.M., A.Z.), Laboratory of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro,”
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G. Palumbo
aFrom the Neuroradiology Unit (G.C.,G.P., F.T.)
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G. Talenti
eNeuroradiology Unit (G.T.), Padua University Hospital, Padua, Italy
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S. Boito
bDivision of Prenatal Diagnosis (S.B.), Istituto Di Ricovero e Cura a Carattere Scientifico Fondazione Ca' Granda Ospedale Policlinico, Milan, Italy
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M. Rustico
fFetal Therapy Unit “Umberto Nicolini” (M.R.), Department of Woman Mother and Neonate
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F. Triulzi
aFrom the Neuroradiology Unit (G.C.,G.P., F.T.)
dDepartment of Pathophysiology and Transplantation (F.T.), Università degli Studi di Milano, Milan, Italy
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A. Righini
gDepartment of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini “V. Buzzi,” Milan, Italy.
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G. Izzo
gDepartment of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini “V. Buzzi,” Milan, Italy.
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C. Doneda
gDepartment of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini “V. Buzzi,” Milan, Italy.
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A. Zolin
cDepartment of Clinical Sciences and Community Health (S.M., A.Z.), Laboratory of Medical Statistics, Biometry and Epidemiology “G.A. Maccacaro,”
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C. Parazzini
gDepartment of Paediatric Radiology and Neuroradiology (A.R., G.I., C.D., C.P.), Ospedale dei Bambini “V. Buzzi,” Milan, Italy.
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  • Fig 1.
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    Fig 1.

    Vermian CCD (the MR imaging trait with the worst percentage disagreement in accuracy between the 2 assessors). Bland-Altman plot of the interassessor B–A difference versus the mean of the measures made on a single fetus. Dashed lines are the limits of agreement for the B–A difference: Ninety-five percent of these differences are expected to lie within these limits when the agreement between the 2 assessors is perfect.

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    Fig 2.

    Pontine APD (the MR imaging trait with the highest correlation of disagreement in accuracy between the 2 assessors and size of MR imaging trait). Bland-Altman plot of the interassessor B–A difference versus the mean of the measures made on a single fetus. Dashed lines are the limits of agreement for the B–A difference: Ninety-five percent of these differences are expected to lie within these limits when the agreement between the 2 assessors is perfect.

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    Fig 3.

    Reference chart for cerebral FOD growth: a whole set of computed centiles (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97th) with observed values. Females are denoted by light gray dots, males by dark gray dots, and fetuses of sex unknown by white dots.

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    Fig 4.

    Reference chart for cerebral BPD growth: a whole set of computed centiles (3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, 97th) with observed values. Females are denoted by light gray dots, males by dark gray dots, and fetuses of sex unknown by white dots.

Tables

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    Table 1:

    Indications for prenatal MR imaging

    Indication for Prenatal MRINo. of Fetuses (%)
    Unclear CNS findings at ultrasound80 (47)
    Extra-CNS disease or malformation30 (18)
    Previous child with a confirmed CNS malformation59 (35)
    • View popup
    Table 2:

    Accuracy and precision of MR imaging measurements

    No.aMeanbB-AcB-A (%)dt TestePSEMfCVSEMgrhP
    PCF16528.610.0220.080.171.1484.010.059
    Cerebral FOD16856.77−3.258−5.74−18.53<.011.6112.840.158<.05
    Cerebral BPD16942.12−1.263−3.00−11.68<.010.9952.36−0.141
    Vermian APD1677.080.0140.200.210.6118.640.192<.05
    Cerebellar LLD16621.81−1.020−4.68−10.41<.010.8934.090.111
    Vermian CCD16810.13−0.934−9.22−13.29<.010.6446.36−0.004
    CSA16872.251.0201.411.775.2787.300.192<.05
    LCC15217.970.1760.981.750.8784.890.071
    LCC/cerebral FOD (%)15131.692.2527.1111.87<.011.6485.200.238<.01
    Thecal FOD16763.470.3600.572.97<.011.1061.740.002
    Thecal BPD16949.740.6821.374.45<.011.4102.830.106
    Mesencephalic APD1184.460.1974.413.08<.010.49010.990.143
    Pontine APD1596.69−0.074−1.10−1.340.4917.340.241<.01
    Pontine CCD1587.53−0.384−5.10−6.24<.010.5477.270.184<.05
    Lateral ventricles1616.760.5688.408.15<.010.6259.25−0.214<.01
    • Note:—SEM indicates standard error of the measurements; APD, antero-posterior diameter; BPD, biparietal diameter; CCD, cranio-caudal diameter; CV, coefficient of variation; CSA, clivosupraoccipital angle; LCC, length of the corpus callosum; LLD, latero-lateral diameter; FOD, fronto-occipital diameter; PCF, latero-lateral diameter of the posterior cranial fossa.

    • ↵a The number of observations.

    • ↵b Mean of all measurements.

    • ↵c Mean difference between assessor B and assessor A (difference in accuracy of assessors A and B).

    • ↵d Percentage interassessor difference [100 × (B−A) / mean].

    • ↵e t test for difference in B−A.

    • ↵f Measuring error—that is, the SD of the measures of the same fetus (lack of precision).

    • ↵g Measuring error expressed as coefficient of variation (%) of (100 × SEM / mean).

    • ↵h Correlation coefficient between interassessor B−A difference and the mean of the measurements made on a single fetus.

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    Table 3:

    Median and reference limits (5th and 95th centiles) for MR imaging traits between 20 and 24 completed weeks of gestation

    20 Weeks21 Weeks22 Weeks23 Weeks24 Weeks
    5th50th95th5th50th95th5th50th95th5th50th95th5th50th95th
    PCF23.326.329.324.627.831.125.929.332.927.230.834.728.532.436.5
    Cerebral FOD46.751.256.450.154.860.253.458.464.156.862.067.960.265.571.7
    Cerebral BPD36.238.741.637.840.944.539.443.047.440.945.250.542.447.353.6
    Vermian APD5.56.37.26.06.87.86.47.38.46.87.89.07.28.39.6
    Cerebellar LLD18.219.921.819.121.123.420.122.425.021.023.626.621.924.928.3
    Vermian CCD7.79.010.08.39.810.98.910.611.99.511.412.810.112.113.8
    CSA63.771.079.963.671.681.563.472.183.263.272.785.063.173.286.8
    LCC13.315.317.114.717.119.216.018.921.417.320.723.618.622.525.8
    LCC/cerebral FOD (%)27.329.932.527.831.134.328.332.336.128.733.538.029.134.739.9
    Thecal FOD53.457.562.156.761.366.660.065.271.263.269.075.766.472.880.4
    Thecal BPD42.145.749.944.448.352.946.750.956.049.053.659.151.356.262.1
    Mesencephalic APD3.64.45.23.74.55.23.84.55.33.84.65.33.94.65.3
    Pontine APD5.56.26.95.76.57.36.06.87.76.37.18.06.57.48.4
    Pontine CCD6.37.17.96.57.48.36.77.78.76.88.09.07.08.29.4
    Lateral ventricles5.77.08.45.36.88.45.06.68.44.76.48.54.56.38.5
    • Note:—APD indicates antero-posterior diameter; BPD, biparietal diameter; CCD, cranio-caudal diameter; CSA, clivosupraoccipital angle; LCC, length of the corpus callosum; LLD, latero-lateral diameter; FOD, fronto-occipital diameter; PCF, latero-lateral diameter of the posterior cranial fossa.

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American Journal of Neuroradiology: 39 (5)
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G. Conte, S. Milani, G. Palumbo, G. Talenti, S. Boito, M. Rustico, F. Triulzi, A. Righini, G. Izzo, C. Doneda, A. Zolin, C. Parazzini
Prenatal Brain MR Imaging: Reference Linear Biometric Centiles between 20 and 24 Gestational Weeks
American Journal of Neuroradiology May 2018, 39 (5) 963-967; DOI: 10.3174/ajnr.A5574

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Prenatal Brain MR Imaging: Reference Linear Biometric Centiles between 20 and 24 Gestational Weeks
G. Conte, S. Milani, G. Palumbo, G. Talenti, S. Boito, M. Rustico, F. Triulzi, A. Righini, G. Izzo, C. Doneda, A. Zolin, C. Parazzini
American Journal of Neuroradiology May 2018, 39 (5) 963-967; DOI: 10.3174/ajnr.A5574
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