Evaluation the angle of posterosuperior horn of normal fetal Sylvian fissure and its morphological changes by trans-cerebellar section

Abstract Objective On the basis of retrospectively analysis the trans-cerebellar section showing the Sylvian fissure of normal fetus is better than trans-thalamic section in middle and late trimester, we prospectively studied the morphological changes of the Sylvian fissure of normal fetus on the trans-cerebellar section in order to provide valuable information for the diagnosis of fetal cerebral cortical dysplasia. Methods A prospective cross-sectional study was conducted on 845 normal fetuses at 21 to 32 weeks of gestation from January 2019 to September 2020. The angle of the posterosuperior horn of the Sylvian fissure was measured. Based on the angle, the morphology of the Sylvian fissure was divided into four shapes included shape (Angle >90°), П shape (Angle ≈90°), π shape (Angle <90°) and 工 shape (Angle ≈0°). Results The angle of the posterosuperior horn of the Sylvian fissure was negatively correlated with gestational age which correlation coefficient was 0.966 (P < 0.001). Taking gestational age as the independent variable and the angle of posterosuperior horn of the Sylvian fissure as the dependent variable, it showed that there was a linear relationship between the gestational age and the angle of posterosuperior horn of the Sylvian fissure. We got a simple correlation formula that the angle of posterosuperior horn of the Sylvian fissure (°) =140-13×(gestational weeks-21). It was found that the morphological changes of the Sylvian fissure were related to the gestational age. The morphology of the Sylvian fissure was -shaped at 21 to 24 weeks of gestation, П-shaped at 25 to 26 weeks of gestation, π-shaped at 26 to 30 weeks of gestation, and the Sylvian fissure was almost closed and appeared 工 shape after 31 to 32 weeks of gestation. Conclusion This study preliminarily elucidates that the morphological changes of the posterosuperior horn of the Sylvian fissure of normal fetuses at 21 to 32 weeks of gestation through the trans-cerebellar section, which could provide valuable information for the evaluation of the normal development of the Sylvian fissure and the prenatal diagnosis of cerebral cortical hypoplasia of fetuses.