Corroboration of normal and abnormal fetal cerebral lamination on postmortem MR imaging with postmortem examination

Abstract

BACKGROUND AND PURPOSE: The presence of normal fetal cerebral lamination of the germinal matrix, intermediate zone, subplate layer, and cortex can be used as a marker of normal fetal cerebral development. Our aim was to compare postmortem MR imaging assessment of normal and abnormal fetal cerebral lamination on T1- and T2-weighted images with histopathology. MATERIALS AND METHODS: Fifty-five formalin-fixed brains from postmortem fetuses, ranging from 16 to 30 weeks' gestational age, mean of 23 weeks, underwent T1- and T2- weighted MR imaging and subsequent sectioning and histologic examination. The cerebral lamination was graded as normal or abnormal on T1- and T2-weighted imaging and compared with postmortem findings. The sensitivity, specificity, and positive and negative predictive values of T1 and T2 assessment of cerebral lamination were calculated. RESULTS: Twenty-six fetuses had abnormal and 29 had normal cerebral lamination on histology. On T1, the overall sensitivity, specificity, and positive and negative predictive values of evaluating cerebral lamination were 96.15% (CI, 78.42%-99.80%), 89.66% (CI, 71.50%-97.29%), 89.29% (CI, 70.63%-97.19%), and 96.29% (CI, 79.11%-99.80%), respectively. On T2, the overall sensitivity, specificity, and positive and negative predictive values of evaluating cerebral lamination were 73.08% (CI, 51.95%-87.65%), 96.55% (CI, 80.37%-99.82%), 95.00% (CI, 73.06%-99.74%), and 80.00% (CI, 62.54%-90.94%), respectively. CONCLUSIONS: Postmortem MR imaging has high sensitivity, specificity, and positive and negative predictive values in assessing fetal cerebral lamination compared with histology. T1-weighted imaging has a higher sensitivity and negative predictive value, while T2-weighted imaging has a higher specificity and positive predictive value.