High resolution post-mortem MRI of non-fixed in situ foetal brain in the second trimester of gestation: Normal foetal brain development

Purpose: To describe normal foetal brain development with high resolution post-mortem MRI (PMMRI) of non-fixed foetal brains. Methods: We retrospectively collected PMMRIs of foetuses without intracranial abnormalities and chromosomal aberrations studied after a termination of pregnancy due to extracranial abnormalities or after a spontaneous intrauterine death. PMMRIs were performed on a 3-T scanner without any fixation and without removing the brain from the skull. All PMMRIs were evaluated in consensus by two neuroradiologists. Results: Our analysis included ten PMMRIs (median gestational age (GA): 21 weeks; range: 17–28 weeks). At 19 and 20 weeks of GA, the corticospinal tracts are recognisable in the medulla oblongata, becoming less visible from 21 weeks. Prior to 20 weeks the posterior limb of the internal capsule (PLIC) is more hypointense than surrounding deep grey nuclei; starting from 21 weeks the PLIC becomes isointense, and is hyperintense at 28 weeks. From 19–22 weeks, the cerebral hemispheres show transient layers: marginal zone, cortical plate, subplate, and intermediate, subventricular and germinal zones. Conclusion: PMMRI of non-fixed in situ foetal brains preserves the natural tissue contrast and skull integrity. We assessed foetal brain development in a small cohort of foetuses, focusing on 19–22 weeks of gestation. Key Points: • Post-mortem magnetic resonance imaging (PMMRI) of non-fixed head is feasible. • PMMRI of unfixed in situ foetal brains preserves the natural tissue contrast. • PMMRI provide a good depiction of the normal foetal brain development. • PMMRI of unfixed in situ foetal brains preserves the skull integrity. • PMMRI pattern of foetal brain development at early gestational age is described.