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Normal fetal development of the cervical, thoracic and lumbar spine: a post-mortem study based on magnetic resonance imaging

Shuai Zhang¹, Xiangtao Lin², Ximing Wang², Xiang Feng³, and Rui Diao²
¹School of Medicine, Shandong First Medical University, School of Medicine, Shandong First Medical University, Jinan, China, ²Department of Radiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China, ³MR Scientific Marketing, Diagnosis Imaging, Siemens Healthcare Ltd, Beijing, China

Synopsis

Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. Postmortem magnetic resonance imaging was performed on 55 fetuses (gestational ages, 17–42 weeks) by using three-dimensional T2-weighted sequences. The volumes of interest were manually outlined for the cervical, thoracic, lumbar, and L1–L5 centrum ossification centers (COCs), and the COC volumes (COCVs) were calculated. The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age.The cervical, thoracic, lumbar, and L1–L5 COCVs show good correlation with gestational age in the second and third trimesters.

Introduction:

Accurate measurement of spinal development is important for the prenatal diagnosis of spinal abnormalities. Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. This study aimed to measure the volumes of the normal fetal cervical, thoracic, and lumbar ossification centers and to study their volumetric changes with gestational age.

Methods:

Postmortem magnetic resonance imaging was performed on 55 fetuses (gestational ages, 17–42 weeks) by using three-dimensional T2-weighted sequences. The volumes of interest were manually outlined for the cervical, thoracic, lumbar, and L1–L5 centrum ossification centers (COCs), and the COC volumes (COCVs) were calculated. The correlation between COCV and gestational age was investigated.

Results:

The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age (P < .01). No gender differences were found in the volumetric development of the cervical, thoracic, and lumbar COCs. The average volumetric growth rate per COC was larger in the lumbar spine than in the cervical and thoracic spine. The L1–L5 COCVs also showed a linear positive relationship with gestational age.

Conclusion:

The cervical, thoracic, lumbar, and L1–L5 COCVs show good correlation with gestational age in the second and third trimesters. The L1 COCV is best suited as a marker for fetal cervical, thoracic, and lumbar development.

Acknowledgements

no acknowledgements

References

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Figures

Fig 1. Sample segmentations of cervical (A), thoracic (B), and lumbar (C) centrum ossification center volumes.

Fig 2. Regression lines for the volumes of the cervical (A), thoracic (B), and lumbar (C) centrum ossification centers.

Fig 3. Centrum ossification centers of the L1–L5 vertebrae in fetuses at 17, 24, 32, and 39 weeks of gestation.

Fig 4. Regression lines for the volumes of the L1 (A), L2 (B), L3 (C), L4 (D), and L5 (E) centrum ossification centers.

Proc. Intl. Soc. Mag. Reson. Med. 29 (2021)

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