Mariusz Baumgart

New patterns of the growing L3 vertebra and its 3 ossification centers in human fetuses – a CT, digital, and statistical study

BACKGROUND This study describes reference data for L3 vertebra and its 3 ossification centers at varying gestational ages. MATERIAL AND METHODS Using CT, digital-image analysis and statistics, the growth of L3 vertebra and its 3 ossification centers in 55 spontaneously aborted human fetuses aged 17-30 weeks was examined. RESULTS Neither sex nor right-left significant differences were found. The height and transverse and sagittal diameters of the L3 vertebral body increased logarithmically. Its cross-sectional area followed linearly, whereas its volume increased parabolically. The transverse and sagittal diameters of the ossification center of the L3 vertebral body varied logarithmically, but its cross-sectional area and volume grew linearly. The ossification center-to-vertebral body volume ratio gradually declined with age. The neural ossification centers increased logarithmically in length and width, and proportionately in cross-sectional area and volume. CONCLUSIONS With no sex differences, the growth dynamics of the L3 vertebral body follow logarithmically in height, sagittal and transverse diameters, linearly (in cross-sectional area), and parabolically (in volume). The growth dynamics of the 3 ossification centers of the L3 vertebra follow logarithmically in transverse and sagittal diameters, and linearly (in cross-sectional area and volume). The age-specific reference intervals of the L3 vertebra and its 3 ossification centers present the normative values of clinical importance in the diagnosis of congenital spinal defects.

New quantitative patterns of the growing trachea in human fetuses

Summary Background Rapid progress in perinatal medicine has resulted in numerous tracheo-bronchial interventions on fetal and neonatal airways. The present study was performed to compile normative data for tracheal dimensions at varying gestational ages. Material/Methods Using anatomical dissection, digital image analysis (NIS-Elements BR 3.0) and statistical analysis (Wilcoxon signed-rank test, Student’s t test, one-way ANOVA, post-hoc Bonferroni test, linear and nonlinear regression analysis) a range of the 4 variables (length in mm, middle external transverse diameter in mm, proximal internal cross-sectional area in mm2, internal volume in mm3) for the trachea in 73 spontaneously aborted human fetuses (39 male, 34 female) aged 14–25 weeks was examined. Results No significant male-female differences were found (P>0.05). The length ranged from 10.37±2.15 to 26.54±0.26 mm as y=−65.098 + 28.796 × ln (Age) ±1.794 (R2=0.82). The middle external transverse diameter varied from 2.53±0.09 to 5.09±0.42 mm with the model y=−11.020 + 5.049 × ln (Age) ±0.330 (R2=0.81). The trachea indicated a proportional evolution because the middle external transverse diameter-to-length ratio was stable (0.23±0.03). The proximal internal cross-sectional area rose from 1.46±0.04 to 5.76±1.04 mm2 as y=−3.562 + 0.352 × Age ±0.519 (R2=0.76). The internal volumetric growth from 11.89±2.49 to 119.63±4.95 mm3 generated the function y=−135.248 + 9.919 × Age ±10.478 (R2=0.86). Conclusions The growth in both length and middle external transverse diameter of the trachea follows logarithmic functions, whereas growth of both its proximal internal cross-sectional area and internal volume follow linear functions. The length and middle external transverse diameter of the trachea develop proportionally to each other. The tracheal dimensions may be helpful in the prenatal diagnosis and monitoring of tracheal malformations and obstructive anomalies of the upper respiratory tract.

Cross-sectional study of C1-S5 vertebral bodies in human fetuses.

Introduction Knowledge on the normative spinal growth is relevant in the prenatal detection of its abnormalities. The present study determines the height, transverse and sagittal diameters, cross sectional area, and volume of individual C1–S5 vertebral bodies. Material and methods Using the methods of computed tomography (CT), digital image analysis, and statistics, the size of C1–S5 vertebral bodies in 55 spontaneously aborted human fetuses aged 17–30 weeks was examined. Results All the 5 examined parameters changed significantly with gestational age (p < 0.01). The mean height of vertebral bodies revealed an increase from the atlas (2.39 ±0.54 mm) to L2 (4.62 ±0.97 mm), stabilized through L3–L4 (4.58 ±0.92 mm, 4.61 ±0.84 mm), and then was decreasing to S5 (0.43 ±1.06 mm). The mean transverse diameter of vertebral bodies was increasing from the atlas (1.20 ±1.96 mm) to L1 (6.24 ±1.46 mm), so as to stabilize through L2–L3 (6.12 ±1.65, 6.12 ±1.61 mm), and finally was decreasing to S5 (0.26 ±0.96 mm). There was an increase in sagittal diameter of vertebral bodies from the atlas (0.82 ±1.34 mm) to T7 (4.76 ±0.85 mm), its stabilization for T8–L4 (4.73 ±0.86 mm, 4.71 ±1.02 mm), and then a decrease in values to S5 (0.21 ±0.75 mm) was observed. The values for cross-sectional area of vertebral bodies were increasing from the atlas (2.95 ±5.25 mm2) to L3 (24.92 ±11.07 mm2), and then started decreasing to S5 (0.48 ±2.09 mm2). The volumetric growth of vertebral bodies was increasing from the atlas (8.60 ±16.40 mm3) to L3 (122.16 ±74.73 mm3), and then was decreasing to S5 (1.60 ±7.00 mm3). Conclusions There is a sharp increase in size of fetal vertebral bodies between the atlas and the axis, and a sharp decrease in size within the sacral spine. In human fetuses the vertebral body growth is characterized by maximum values in sagittal diameter for T7, in transverse diameter for L1, in height for L2, and in both cross-sectional area and volume for L3.

Quantitative anatomy of the growing clavicle in the human fetus: CT, digital image analysis, and statistical study

PurposesKnowledge of dimensions of fetal long bones is useful in both the assessment of fetal growth and early detection of inherited defects. Measurements of the fetal clavicle may facilitate detection of numerous defects, e.g., cleidocranial dysplasia, Holt–Oram syndrome, Goltz syndrome, and Melnick–Needles syndrome.MethodsUsing the methods of CT, digital image analysis, and statistics, the size of the growing clavicle in 42 spontaneously aborted human fetuses (21 males and 21 females) at ages of 18–30 weeks was studied.ResultsWithout any male–female and right–left significant differences, the best fit growth models for the growing clavicle with relation to age in weeks were as follows: y = −54.439 + 24.673 × ln(age) ± 0.237 (R2 = 0.86) for length, y = −12.042 + 4.906 × ln(age) ± 0.362 (R2 = 0.82) for width of acromial end, y = −4.210 + 2.028 × ln(age) ± 0.177 (R2 = 0.77) for width of central part, y = −4.687 + 2.364 × ln(age) ± 0.242 (R2 = 0.70) for width of sternal end, y = −51.078 + 4.174 × ln(age) ± 6.943 (R2 = 0.82) for cross-sectional area, and y = −766.948 + 281.774 × ln(age) ± 19.610 (R2 = 0.84) for volume.ConclusionsWith no sex and laterality differences, the clavicle grows logarithmically with respect to its length, width, and volume, and linearly with respect to its projection surface area. The obtained morphometric data of the growing clavicle are considered normative for their respective weeks of gestation and may be of relevance in the diagnosis of congenital defects.

Ossification center of the humeral shaft in the human fetus: a CT, digital, and statistical study

PurposeThe knowledge of the development of the humeral shaft ossification center may be useful both in determining the fetal stage and maturity and for detecting congenital disorders, as well. This study was performed to quantitatively examine the humeral shaft ossification center with respect to its linear, planar, and volumetric parameters.Materials and methodUsing methods of CT, digital image analysis, and statistics, the size of the humeral shaft ossification center in 48 spontaneously aborted human fetuses aged 17–30 weeks was studied.ResultsWith no sex differences, the best-fit growth dynamics for the humeral shaft ossification center was modeled by the following functions: y = −78.568 + 34.114 × ln (age) ± 2.160 for its length, y = −12.733 + 5.654 × ln(age) ± 0.515 for its proximal transverse diameter, y = −4.750 + 2.609 × ln (age) ± 0.294 for its middle transverse diameter, y = −10.037 + 4.648 × ln (age) ± 0.560 for its distal transverse diameter, y = −146.601 + 11.237 × age ± 19.907 for its projection surface area, and y = 121.159 + 0.001 × (age)4 ± 102.944 for its volume.ConclusionsWith no sex differences, the ossification center of the humeral shaft grows logarithmically with respect to its length and transverse diameters, linearly with respect to its projection surface area, and fourth-degree polynomially with respect to its volume. The obtained morphometric data of the humeral shaft ossification center are considered normative for respective prenatal weeks and may be of relevance in both the estimation of fetal ages and the ultrasonic diagnostics of congenital defects.

Morphometric study of the triangle of Petit in human fetuses

BACKGROUND The inferior lumbar triangle of Petit is bounded by the iliac crest, lateral border of the latissimus dorsi and the medial border of the external oblique. OBJECTIVES In the present study, we aimed to quantitatively examine the base, sides, area, and interior angles of the inferior lumbar triangle in the human fetus so as to provide their growth dynamics. MATERIAL AND METHODS Using anatomical dissection, digital image analysis (NIS-Elements AR 3.0), and statistics (Students t-test, regression analysis), we measured the base, 2 sides, area and interior angles of Petits triangle in 35 fetuses of both sexes (16 male, 19 female) aged 14-24 weeks. RESULTS Neither sex nor laterality differences were found. All the parameters studied increased commensurately with age. The linear functions were computed as follows: y = -0.427 + 0.302 × age for base, y = 1.386 + 0.278 × age for medial side, y = 0.871 + 0.323 × age for lateral side, and y = -13.230 + 1.590 × age for area of the Petit triangle. CONCLUSIONS In terms of geometry, Petit triangle reveals neither male-female nor right-left differences. An increase in both lengths and area of the inferior lumbar triangle follows proportionately. The Petit triangle is an acute one in the human fetus.