Fetal cerebellar growth and Sylvian fissure maturation: international standards from Fetal Growth Longitudinal Study of INTERGROWTH-21st Project.

OBJECTIVE: To construct international ultrasound-based standards for fetal cerebellar growth and Sylvian fissure maturation. METHODS: Healthy, well nourished pregnant women, enrolled at < 14 weeks' gestation in the Fetal Growth Longitudinal Study (FGLS) of INTERGROWTH-21st , an international multicenter, population-based project, underwent serial three-dimensional (3D) fetal ultrasound scans every 5 ± 1 weeks until delivery in study sites located in Brazil, India, Italy, Kenya and the UK. In the present analysis, only those fetuses that underwent developmental assessment at 2 years of age were included. We measured the transcerebellar diameter and assessed Sylvian fissure maturation using two-dimensional ultrasound images extracted from available 3D fetal head volumes. The appropriateness of pooling data from the five sites was assessed using variance component analysis and standardized site differences. For each Sylvian fissure maturation score (left or right side), mean gestational age and 95% CI were calculated. Transcerebellar diameter was modeled using fractional polynomial regression, and goodness of fit was assessed. RESULTS: Of those children in the original FGLS cohort who had developmental assessment at 2 years of age, 1130 also had an available 3D ultrasound fetal head volume. The sociodemographic characteristics and pregnancy/perinatal outcomes of the study sample confirmed the health and low-risk status of the population studied. In addition, the fetuses had low morbidity and adequate growth and development at 2 years of age. In total, 3016 and 2359 individual volumes were available for transcerebellar-diameter and Sylvian-fissure analysis, respectively. Variance component analysis and standardized site differences showed that the five study populations were sufficiently similar on the basis of predefined criteria for the data to be pooled to produce international standards. A second-degree fractional polynomial provided the best fit for modeling transcerebellar diameter; we then estimated gestational-age-specific 3rd , 50th and 97th smoothed centiles. Goodness-of-fit analysis comparing empirical centiles with smoothed centile curves showed good agreement. The Sylvian fissure increased in maturation with advancing gestation, with complete overlap of the mean gestational age and 95% CIs between the sexes for each development score. No differences in Sylvian fissure maturation between the right and left hemispheres were observed. CONCLUSION: We present, for the first time, international standards for fetal cerebellar growth and Sylvian fissure maturation throughout pregnancy based on a healthy fetal population that exhibited adequate growth and development at 2 years of age. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Enlarged Sylvian fissures in infants with interstitial deletion of chromosome 22q11.

Two infants with chromosome 22q11 deletion syndrome were noted to have symmetrically enlarged Sylvian fissures on cranial MRI. We compared the size of the Sylvian fissures in neuroimaging studies from 17 other subjects with del 22q11 to age-matched disease controls. The mean anterior interopercular distance was used as an index of Sylvian fissure enlargement. Symmetric enlargement of the Sylvian fissures was present in 10 of 17 subjects with del 22q11. The age-incidence pattern, as well as follow-up scans in 2 patients, suggests delayed growth of the opercular region in these patients. Subjects with del 22q11 consistently had disproportionate enlargement of the left Sylvian fissure compared to the right. This observation suggests that a gene (or genes) in the deleted region affects the development of the left and right perisylvian cortex in different ways. Abnormal development of the operculum may explain some of the neurodevelopmental features that are common among individuals with 22q11 deletion syndrome.

Postnatal development and specification of the cat's visual corticotectal projection: efferents from the posteromedial lateral suprasylvian area.

The corticotectal projection in adult cats has a precise topographic and laminar organization. Yet this projection initially grows beyond these adult targets. To begin to understand how the growing cortical axons achieve this precision, the morphological development of axons growing from the posteromedial lateral suprasylvian area (PMLS) to the superior colliculus was studied by injecting the anterograde tracer biocytin into the PMLS of cats between postnatal day (P0) and adulthood. The labeling patterns showed that (1) axons grow independently towards the colliculus and (2) the first axons from the PMLS arrive in the colliculus by P1 and continue to arrive over several days. Labeled growth cones were seen within the colliculus up to P15. (3) After reaching the colliculus, the axons undergo several morphological changes. Initially, they are unbranched and beaded, then short side branches are formed and finally extensive arborizations appear. Comparing the timing of these events with results from electron microscopic and electrophysiological studies suggests that the appearance and increase in labeled axons with short side branches roughly coincides with the appearance and increase in number of synapses in the colliculus, whereas the elaboration of extensive arbors (and hence a corresponding increase in synapses) is well underway before visual cortical influences on the colliculus can be measured. Thick sinuous axons are also labeled during maturation, usually in areas of the colliculus where they would be considered exuberant and may represent degenerating axons. (4) A coarse topography develops as the axons grow into the colliculus and becomes more precise in the following weeks. Initially, some axons extend well beyond their correct terminal zone, growing into the contralateral colliculus, caudally into the inferior colliculus and reaching all laminae of the ipsilateral superior colliculus. Similar targeting 'errors' have been reported during the growth of retinotectal axons, suggesting that cortical, retinal and perhaps other sources as well, may use the same extracellular cues to establish an initial coarse topography within the colliculus.

MR of the cerebral operculum: topographic identification and measurement of interopercular distances in healthy infants and children.

PURPOSE: To evaluate the role of axial, coronal, and sagittal MR in identification of surface landmarks of the cerebral operculum and to determine the reference values of interopercular distances of each hemisphere in healthy infants and children on MR images. METHODS: Two hundred fourteen cerebral opercula of 35 healthy infants and 72 healthy children were retrospectively evaluated from 107 routine MR brain examinations. The surface landmarks of the operculum and interopercular distances of each hemisphere, which were subjectively divided into anterior interopercular distance (anterior sylvian width) and posterior interopercular distance (posterior sylvian width), were recorded from axial, coronal, and sagittal MR images, respectively. The mean value of anterior interopercular distance of each hemisphere was obtained by averaging two linear measurements of the anterior sylvian width from lateral, sagittal, and axial planes of the same side. Likewise, the posterior interopercular distance of each side of the brain was obtained from averaging of two measurements on lateral, sagittal, and coronal planes. RESULTS: The landmarks of the operculum were best identified by sagittal MR, followed by axial and coronal images. The average values of left anterior interopercular distance, right anterior interopercular distance, left posterior interopercular distance, and right posterior interopercular distance in infants were 1.9 +/- 1.3, 1.6 +/- 1.1, 0.4 +/- 0.7, and 0.2 +/- 0.4 mm, and in children, 0.9 +/- 1.3, 1.0 +/- 1.4, 0.03 +/- 0.23, and 0.01 +/- 0.07 mm, respectively. Infants showed significantly wider interopercular distances than children. Left anterior interopercular distance was significantly wider than right in infants, but not in children. Male children displayed a more significant increase in anterior interopercular distance than did female children. There was no statistic difference in measurements of anterior interopercular distance and posterior interopercular distance between female and male infants. CONCLUSIONS: The operculum should be evaluated with MR in three planes. Infants may show conspicuous sylvian fissures that should not exceed 4.5 mm (mean + 2 SD) anteriorly on axial and sagittal planes and 1.8 mm posteriorly on sagittal and coronal planes. Healthy children who have fully developed opercula should have an anterior interopercular distance of no more than 3.5 mm and a posterior interopercular distance of 0.5 mm.

Relationship of age with the size of the interventricular foramina and aqueductus sylvii: a morphometric evaluation.

OBJECTIVES: The ventricular system is an essential part of the brain. Various pathologies directly or indirectly affect the size of this system. Morphometric analysis of the cerebral ventricular system is important for evaluating changes due to growth, aging, and intrinsic and extrinsic pathologies. The aim of this study was to evaluate the normative data for the interventricular foramina and cerebral aqueduct with regard to surgery and clinical situations. METHODS: Cranial magnetic resonance imaging (MRI) scans of 128 healthy subjects (63 female subjects, 65 male subjects; 2-63 years old) were individually reviewed. The right and left interventricular foramina lengths and diameters and the cerebral aqueduct length and diameter were statistically evaluated and compared between sexes and among age groups. RESULTS: There were no significant differences among the age groups in either sex (P > 0·05). Additionally, there was no correlation between age and measurement parameters (P > 0·05). DISCUSSION: We did not observe any changes in interventricular foramina or cerebral aqueduct measurements in healthy subjects from a wide range of age groups. Such changes should be useful for diagnosing diseases that affect the ventricular system and planning surgical procedures, especially those involving the ventricular system.

Cine phase-contrast MRI evaluation of normal aqueductal cerebrospinal fluid flow according to sex and age.

PURPOSE: The aim of this study was cerebrospinal flow quantification in the cerebral aqueduct using cine phase-contrast magnetic resonance imaging (MRI) technique in both sexes and five different age groups to provide normative data. MATERIALS AND METHODS: Sixty subjects with no cerebral pathology were included in this study. Subjects were divided into five age groups: < or =14 years, 15-24 years, 25-34 years, 35-44 years, and > or =45 years. Phase, rephase, and magnitude images were acquired by 1.5 T MR unit at the level of cerebral aqueduct with spoiled gradient echo through-plane, which is a cine phase-contrast sequence. At this level, peak flow velocity (cm/s), average flow rate (cm/ s), average flow (L/min), volumes in cranial and caudal directions (mL), and net volumes (mL) were studied. RESULTS: There was a statistically significant difference in peak flow between the age group of < or =14 years and the older age groups. There were no statistically significant differences in average velocity, cranial and caudal volume, net volume, and average flow parameters among different age groups. Statistically significant differences were not detected in flow parameters between sexes. CONCLUSION: When using cine-phase contrast MRI in the cerebral aqueduct, only the peak velocity showed a statistically significant difference between age groups; it was higher in subjects aged < or =14 years than those in older age groups. When performing age-dependent clinical studies including adolescents, this should be taken into consideration.

Scanning electron microscopy of transitory subependymal cysts in the developing midbrain of postnatal rats.

Transitory cystic cavities, associated with the subependymal region of the aqueduct in the midbrain of postnatal rats aged 1-15 days, were studied by light and scanning electron microscopy. The walls of these cysts, as observed in scanning electron microscopy, were lined by a dense feltwork of nerve fibres. Two types of cells were identified in the cysts: smaller glioblasts and larger amoeboid microglial cells. The glioblasts were characterized by a smoother cell body with radiating long processes. The amoeboid microglial cells showed blebs and pseudopodia on their surface. They either adhered to the walls or floated freely in the lumen. It is postulated that the formation of the subependymal cysts in the developing brain resulted following the cleavage or breakdown of the nervous tissue due to the expansion of the aqueduct and the brain as a whole. The amoeboid microglial cells in the cysts were probably derived from the extravasated blood monocytes in response to the physical damage ensuing during the formation of the cysts.