MR microscopy of the human fetal upper extremity – a proof-of-principle study

Langner, Inga; Stahnke, Thomas; Stachs, Oliver; Lindner, Tobias; Kühn, Jens‐Peter; Kim, Simon; Wree, Andreas; Langner, Soenke

doi:10.1186/s12861-016-0123-z

Cited by 8 publications

(11 citation statements)

References 17 publications

(33 reference statements)

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“…Few MRI experiments showed nervous structures, in particular Pacinian corpuscles in vivo in the fingertip at 1.5 T (13) and in the toe at 3 T (14). In a cadaver study, 76 mm in-plane MRI images of the fingertip acquired in a small-bore 7T-scanner have been demonstrated and correlated with histology (15).…”

Section: Introductionmentioning

confidence: 99%

In vivo MRI of the human finger at 7 T

Laistler

Dymerska

Sieg

et al. 2017

Magnetic Resonance in Med

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PurposeTo demonstrate a dedicated setup for ultrahigh resolution MR imaging of the human finger in vivo.MethodsA radiofrequency coil was designed for optimized signal homogeneity and sensitivity in the finger at ultrahigh magnetic field strength (7 T), providing high measurement sensitivity. Imaging sequences (2D turbo‐spin echo (TSE) and 3D magnetization‐prepared rapid acquisition gradient echo (MPRAGE)) were adapted for high spatial resolution and good contrast of different tissues in the finger, while keeping acquisition time below 10 minutes. Data was postprocessed to display finger structures in three dimensions.Results3D MPRAGE data with isotropic resolution of 200 µm, along with 2D TSE images with in‐plane resolutions of 58 × 78 µm2 and 100 × 97 µm2, allowed clear identification of various anatomical features such as bone and bone marrow, tendons and annular ligaments, cartilage, arteries and veins, nerves, and Pacinian corpuscles.ConclusionUsing this dedicated finger coil at 7 T, together with adapted acquisition sequences, it is possible to depict the internal structures of the human finger in vivo within patient‐compatible measurement time. It may serve as a tool for diagnosis and treatment monitoring in pathologies ranging from inflammatory or erosive joint diseases to injuries of tendons and ligaments to nervous or vascular disorders in the finger. Magn Reson Med 79:588–592, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

In vivo MRI of the human finger at 7 T

Laistler

Dymerska

Sieg

et al. 2017

Magnetic Resonance in Med

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“…Prior to 15 weeks, the ratio is steadily increasing from 0.4 to 0.5, which suggests that at gestational ages less than 15 weeks, the metacarpal growth or endochondral ossification is delayed relative to that of the phalanges. Established patterns of limb development describe ossification of the distal phalanges around 8 weeks, then the metacarpals, followed by the proximal and medial phalanges at approximately 9 to 11 weeks of gestation . While the exact growth patterns of the bones in the fetal hand have not been previously described, we believe that our ultrasound‐derived results describe normative growth patterns.…”

Section: Discussionmentioning

confidence: 99%

“…Established patterns of limb development describe ossification of the distal phalanges around 8 weeks, then the metacarpals, followed by the proximal and medial phalanges at approximately 9 to 11 weeks of gestation. 14,15 While the exact growth patterns of the bones in the fetal hand have not been previously described, we believe that our ultrasound-derived results describe normative growth patterns.…”

Section: Discussionmentioning

confidence: 99%

A new biometric: In utero growth curves for metacarpal and phalangeal lengths reveal an embryonic patterning ratio

et al. 2019

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Objectives The objectives of this study are to develop gestational age‐specific growth curves for fetal third metacarpal and phalangeal lengths and to determine if fetal hand proportion is established in utero. Methods This prospective cross‐sectional study used 2D ultrasound across gestational ages 12 to 39 weeks to evaluate the third fetal metacarpal and phalangeal measurements. Gestational age‐specific reference growth curves were developed. Associations between continuous variables were assessed using Spearman correlations (rs) and restricted cubic splines. A nonlinear biologic regression model was used to predict metacarpal and phalangeal lengths as a function of gestational age. Measurements derived from five cases of thanatophoric dysplasia were used to determine if brachydactyly could be objectified. Results Fetal metacarpal and phalangeal lengths are highly correlated across gestational age (rs = 0.96, P < 0.001). The mean fetal metacarpal to phalangeal ratio is constant from gestational age 15 to 39 weeks (rs = −0.07, P = 0.49). Third‐digit metacarpal and phalangeal lengths in thanatophoric dysplasia showed brachydactyly in all cases (5/5), and none of the cases (0/5) demonstrated a normal metacarpal to phalangeal ratio of 0.49. Conclusion We present gestational age‐specific reference growth curves for fetal third metacarpal and phalangeal lengths, which may be used to detect brachydactyly. We demonstrate a prenatal metacarpal to phalangeal ratio of 1:2.

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“…US examinations will be less accurate later in pregnancy, due to fetal position and flexed digits [37]. By some authors, the use of three-dimensional (3D) and 4D US, as well as fetal MRI, improves detection of hand anomalies [32,[37][38][39][40][41][42]. However, the technique is not currently recommended for routine use by The American College of Obstetricians and Gynecologists [3,33].…”

Section: Techniquementioning

confidence: 99%

The Antenatal Detection of Fetal Limb Anomalies

Ceaușu¹,

Iliescu²,

Poalelungi³

et al. 2018

Congenital Anomalies - From the Embryo to the Neonate

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The etiology of fetal limb abnormalities is very complex, involving different risk factors: chromosomal abnormalities, gene disorders, intrauterine factors, maternal diseases, or exposure to different risk factors. The prevalence of fetal limb anomalies is reported to be approximately 6 in 10,000 live births, and the impairments of the upper limbs seem to present a higher incidence in comparison to the inferior limbs, more often are affected unilaterally and on the right side in comparison to the left side, some being isolate or may associate other anomalies, as a part of an underlying syndrome. According to the current guidelines, the assessment of the fetal limbs should be performed in the late first and early second trimester. Three-dimensional ultrasound provides a better understanding of the fetal anomaly for the parents and helps a better counseling, and it is used to confirm the anomalies detected by the conventional ultrasound. In cases of treatable anomalies, a multidisciplinary approach involving an obstetrician, geneticist, neonatologist, pediatrician, and pediatric orthopedic surgeon is essential to improve the postnatal outcome. Ultrasound examination and genetic counseling for the parents has an important benefit since some conditions present a genetic inheritance, and the recurrence rate in further pregnancies is very high.

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MR microscopy of the human fetal upper extremity – a proof-of-principle study

Cited by 8 publications

References 17 publications

In vivo MRI of the human finger at 7 T

In vivo MRI of the human finger at 7 T

A new biometric: In utero growth curves for metacarpal and phalangeal lengths reveal an embryonic patterning ratio

The Antenatal Detection of Fetal Limb Anomalies

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