In vivo MR study of brain maturation in normal fetuses.

PURPOSE To illustrate normal maturation of the fetal brain, including the migrational layer, gray matter, early myelination of internal capsules, optic radiations, and corona radiata. METHODS Seventy-seven fetal brains, ranging from 21 to 38 weeks of gestational age, were examined with MR in vivo; 33 were considered normal. MR examinations were performed as T1-weighted sequences in the axial, sagittal, and coronal planes. The neuropathologic examination (four cases) and clinical and/or neuroradiologic examinations confirmed the antenatal data. RESULTS From 21 to 25 weeks, the cerebral ventricles are large, corresponding to the relative fetal hydrocephalus. A slight high signal intensity can be observed in the basal ganglia as early as 21 weeks. In the cerebral hemispheres, a multilayered pattern that can be observed from 23 to 28 weeks includes the cortical ribbon, the germinal matrix, and an intermediate layer corresponding to the migrating glial cells. These findings are probably related to areas of increased cellularity. A high signal intensity can be seen within the dorsal part of the brain stem as early as 23 weeks, within the posterior limb of the internal capsules at 31 weeks, and within the central area of the cerebral hemispheres at 35 weeks. Those patterns are probably caused by the evolving process of myelination. CONCLUSIONS MR allows depiction of signal changes corresponding either to an increase in cellularity or to the evolving processes of myelination, depending on the stage of the pregnancy.