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Fetal Posterior Fossa Volume: Assessment with MR Imaging¹

Sara C. Chen, MD, Erin M. Simon, MD, John C. Haselgrove, PhD, Larissa T. Bilaniuk, MD, Leslie N. Sutton, MD, Mark P. Johnson, MD, David M. Shera, PhD and Robert A. Zimmerman, MD

¹ From the Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pa (S.C.C., E.M.S., L.T.B., L.N.S., M.P.J., R.A.Z.); and Department of Radiology, the Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104-4399 (E.M.S., J.C.H., L.T.B., L.N.S., M.P.J., D.M.S., R.A.Z.). Received July 27, 2004; revision requested October 5; revision received March 21, 2005; accepted April 18; final version accepted, May 25. Address correspondence to E.M.S. (e-mail: Simon{at}email.chop.edu).

View larger version (163K): [in a new window]   Figure 1a: Half-Fourier rapid acquisition with relaxation enhancement MR images (62/5) of brain in representative 21-week-old fetus in (a) sagittal, (b) coronal, and (c) transverse planes. Outlined in white are the boundaries of the posterior fossa, which include the entire cerebellum, brainstem, and extraaxial spaces.

View larger version (159K): [in a new window]   Figure 1b: Half-Fourier rapid acquisition with relaxation enhancement MR images (62/5) of brain in representative 21-week-old fetus in (a) sagittal, (b) coronal, and (c) transverse planes. Outlined in white are the boundaries of the posterior fossa, which include the entire cerebellum, brainstem, and extraaxial spaces.

View larger version (168K): [in a new window]   Figure 1c: Half-Fourier rapid acquisition with relaxation enhancement MR images (62/5) of brain in representative 21-week-old fetus in (a) sagittal, (b) coronal, and (c) transverse planes. Outlined in white are the boundaries of the posterior fossa, which include the entire cerebellum, brainstem, and extraaxial spaces.

View larger version (33K): [in a new window]   Figure 2: Bland-Altman plots for PFV measurements on transverse, coronal, and sagittal MR images. Numbers on x-axis indicate the average value of PFV in cubic centimeters obtained from the two planes listed. On the y-axis, for example, Coronal – Axial in mm3 indicates the difference (in cubic millimeters) between the APFV values obtained from these two planes. Dashed lines represent 95% confidence intervals.

View larger version (21K): [in a new window]   Figure 3: APFV versus EGA. Graph shows APFV in cubic centimeters as a function of EGA in weeks. Each symbol represents the APFV for a single study fetus. Exact EGA was calculated and plotted as a decimal number (eg, 20 weeks 4 days = 20 weeks 4/7 days = 20.57 weeks). The central dark line represents the mathematical model of the data, which is the exponential function [APFV = 0.689 exp(EGA/9.10)]. APFV doubling time is 6.31 weeks, and the root-mean-square value is 1.63 cm3. The outer dark lines represent twice the root-mean-square value calculated without the fetuses older than 30 weeks gestation. The outer light lines represent twice the root-mean-square value calculated with the fetuses older than 30 weeks gestation. There is no significant difference.