• Yuval Ginsberg, Oryan Ganor-Ariav, Hadeel Hussein, Dan Adam, Nizar Khatib, Zeev Weiner, Ron Beloosesky, and Israel Goldstein.
• Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
• J Neuroimaging. 2021 Mar 1; 31 (2): 372-378.

Background And PurposeThe fetal brain changes significantly throughout gestation. From a smooth (lissencephalic) cortex, it transforms into its convolved (gyrencephalic) state. Despite its importance, the diagnosis of delay in brain gyrogenesis is a challenge for many sonographers. This study presents a novel semiautomatic image processing algorithm for simple quantification of sagittal sulci maturation in the third trimester.MethodsMid-sagittal fetal brain ultrasound images were obtained during routine third trimester scans. Fetal brain sulci length measurements were performed using a novel semiautomatic image processing algorithm followed by manual measurements. Correlations between the total length of the sulci, gestational age, and fetal biometry were examined.ResultsThe study included 64 patients. A significant positive linear correlation was found between total sulci length and gestational age (r = .658 for automated measurement, r = .7 for manual measurement, P < .0001). A similar relationship was found comparing total sulci length and fetal head circumference (r = .694 for automated measurement, r = .74 for manual measurement; P < .0001). A significant correlation was observed between automated and manual measurements (r = .947).ConclusionsWe found that fetal gyrogenesis is linear throughout the third trimester of pregnancy. The use of a computer algorithm to measure fetal sulci can be used as a simple prenatal screening test for delayed gyral maturation of the fetal brain.© 2020 American Society of Neuroimaging.

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