TY - JOUR
T1 - Sexual dimorphism of the fetal brain biometry
T2 - an MRI-based study
AU - Gafner, Michal
AU - Kedar Sade, Eliel
AU - Barzilay, Eran
AU - Katorza, Eldad
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Purpose: Fetal growth assessment is a key component of prenatal care. Sex-specific fetal brain nomograms on ultrasound are available and are clinically used. In recent years, the use of fetal MRI has been increasing; however, there are no sex-specific fetal CNS nomograms on MRI. The study aimed to assess the differences in fetal brain biometry and growth trajectories and to create population-based standards of the fetal brain on MRI. Methods: In this cross-sectional study, brain structures of singleton fetuses with normal brain MRI scans were analyzed: biparietal diameter, occipitofrontal diameter, trans-cerebellar diameter, and the corpus callosum were measured and converted into centiles. Sex-specific nomograms were created. Results: A total of 3848 MRI scans were performed in one tertiary medical center between 2011 and 2019; of them, 598 fetuses met the inclusion criteria, 300 males and 298 females between 28- and 37-weeks’ gestation. Males had significantly larger occipitofrontal diameter than females (median 75%, IQR 54–88%; median 61%, IQR 40–77%) and biparietal diameter (median 63%, IQR 42–82%; median 50%, IQR 25–73%), respectively (p < 0.001). The cerebellum had the greatest growth rate, with a 1.5-fold increase in diameter between 28 and 37 weeks’ gestation, with no measurement difference between the sexes (p = 0.239). No significant difference was found in the corpus callosum (p = 0.074). Conclusion: Measuring both sexes on the same nomograms may result in over-estimation of male fetuses and under-estimation of females. We provide fetal sex-specific nomograms on two-dimensional MRI.
AB - Purpose: Fetal growth assessment is a key component of prenatal care. Sex-specific fetal brain nomograms on ultrasound are available and are clinically used. In recent years, the use of fetal MRI has been increasing; however, there are no sex-specific fetal CNS nomograms on MRI. The study aimed to assess the differences in fetal brain biometry and growth trajectories and to create population-based standards of the fetal brain on MRI. Methods: In this cross-sectional study, brain structures of singleton fetuses with normal brain MRI scans were analyzed: biparietal diameter, occipitofrontal diameter, trans-cerebellar diameter, and the corpus callosum were measured and converted into centiles. Sex-specific nomograms were created. Results: A total of 3848 MRI scans were performed in one tertiary medical center between 2011 and 2019; of them, 598 fetuses met the inclusion criteria, 300 males and 298 females between 28- and 37-weeks’ gestation. Males had significantly larger occipitofrontal diameter than females (median 75%, IQR 54–88%; median 61%, IQR 40–77%) and biparietal diameter (median 63%, IQR 42–82%; median 50%, IQR 25–73%), respectively (p < 0.001). The cerebellum had the greatest growth rate, with a 1.5-fold increase in diameter between 28 and 37 weeks’ gestation, with no measurement difference between the sexes (p = 0.239). No significant difference was found in the corpus callosum (p = 0.074). Conclusion: Measuring both sexes on the same nomograms may result in over-estimation of male fetuses and under-estimation of females. We provide fetal sex-specific nomograms on two-dimensional MRI.
KW - Brain
KW - Central nervous system
KW - Fetus
KW - Magnetic resonance imaging
KW - Sex characteristics
UR - http://www.scopus.com/inward/record.url?scp=85139987079&partnerID=8YFLogxK
U2 - 10.1007/s00404-022-06818-4
DO - 10.1007/s00404-022-06818-4
M3 - Article
C2 - 36253494
AN - SCOPUS:85139987079
SN - 0932-0067
VL - 308
SP - 1257
EP - 1262
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 4
ER -