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Abstract
Objective: The study aims to set reference ranges for the cerebellar area, across gestation. The fetal cerebellar area is measured in 150 low‑risk pregnancies. The fetal cerebellar area is measured with 2D ultrasonography (2D‑US).
Methods: This a prospective cross-sectional study was carried out at specialized gynecology and obstetric center in south of Iraq . We enrolled one hundred fifty women who had a single baby and who had accurate pregnancy dates. Healthy pregnant women were, between 18 and 38 weeks of gestation. We manually tracing ,the outline of cerebellar area in the transverse view of the cerebellum. We performed regression analysis to model the relation between the measured cerebellar area and gestational age (GA). We built reference tables.
Results : Women mean age in this study, was 28.7 plus or minus 4.5 years. The mean gestational age at the scan was 27.8 plus or minus 5.1 weeks. We found that the fetal cerebellar area had a linear correlation, with the advancing gestational age. We recorded the correlation coefficient as r = 0.95 and the p value as than 0.001. I derived the regression equation for the area: Cerebellar Area (cm²) = -2.481. 0.257 × GA[weeks]). We created nomograms that show the 95th percentiles, for each gestational week from 18 to 38 weeks. We did not find a correlation between the area and the maternal Body Mass Index (BMI). The correlation was (r = 0.08 p = 0.32
The study provides 2D‑US nomograms, for the cerebellar area from a cohort of 150 patients. The 2D‑US nomograms are a simple tool. The 2D‑US nomograms serve as a tool in prenatal screening, for posterior fossa anomalies.
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Copyright (c) 2025 Firas Abdullah AlBaghdadi (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
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References
- Pertl B, Eder S, Stern C, Verheyen S. The fetal posterior fossa on prenatal ultrasound imaging: normal longitudinal development and posterior fossa anomalies. Ultraschall Med. 2019;40(6):692–721. English. https://doi.org/10.1055/a-1015-0157. Epub 2019 Dec 3. PMID:31794996.
- Alsehli H, Alshahrani SM, Alzahrani S, Ababneh F, Alharbi NM, Alarfaj N, Baarmah D. Fetal and neonatal outcomes of posterior fossa anomalies: a retrospective cohort study. Sci Rep. 2024;14(1):8411. https:10.1038/s41598-024-59163-8. PMID:38600369; PMCID:PMC11006671.
- Bavini S, Mittal R, Mendiratta SL. Ultrasonographic measurement of the transcerebellar diameter for gestational age estimation in the third trimester. J Ultrasound. 2022;25(2):281–287. https://doi.org/10.1007/s40477-021-00564-0. Epub 2021 Mar 9. PMID:33687690; PMCID:PMC9148337.
- de Barros FS, Bussamra LC, Araujo Júnior E, de Freitas LS, Nardozza LM, Moron AF, Aldrighi JM. Comparison of fetal cerebellum and cisterna magna length by 2D and 3D ultrasonography between 18 and 24 weeks of pregnancy. ISRN Obstet Gynecol. 2012;2012:286141. https://doi.org/10.5402/2012/286141. Epub 2012 Nov 14. PMID:23209923; PMCID:PMC3504390.
- Spinelli M, Sica C, Meglio L, Bolla D, Raio L, Surbek D. Fetal cerebellar vermis circumference measured by two-dimensional ultrasound scan: reference range, feasibility and reproducibility. Ultrasound Int Open. 2016;2(4):E124–E128. https://doi.org/10.1055/s-0042-119952.
- Reece EA, Goldstein I, Pilu G, Hobbins JC. Fetal cerebellar growth unaffected by intrauterine growth retardation: a new parameter for prenatal diagnosis. Am J Obstet Gynecol. 1987;157(3):632–638. https://doi.org/10.1016/S0002-9378(87)80019-4. PMID:3307422.
- Pickut BA, Dierckx RA, Dobbeleir A, Audenaert K, Van Laere K, Vervaet A, De Deyn PP. Validation of the cerebellum as a reference region for SPECT quantification in patients suffering from dementia of the Alzheimer type. Psychiatry Res. 1999;90(2):103–112. https://doi.org/10.1016/S0925-4927(99)00004-9. PMID:10482382.
- Scott JA, Hamzelou KS, Rajagopalan V, Habas PA, Kim K, Barkovich AJ, Glenn OA, Studholme C. Three-dimensional morphometric analysis of human fetal cerebellar development. Cerebellum. 2012;11(3):761–770. https://doi.org/10.1007/s12311-011-0338-2. PMID:22198870; PMCID:PMC3389138.
- Wu KH, Chen CY, Shen EY. Cerebellar development in Chinese children: a study using voxel-based volume measurement of reconstructed 3D MRI scans. Pediatr Res. 2011;69(1):80–83. https://doi.org/10.1203/PDR.0b013e3181ff2f6c. PMID:20924316.
- Gasperini C, Rovaris M, Sormani MP, Bastianello S, Pozzilli C, Comi G, et al. Intra-observer, inter-observer and inter-scanner variations in brain MRI volume measurements in multiple sclerosis. Mult Scler. 2001;7(1):27–31. https://doi.org/10.1177/135245850100700106.
- Lacomba-Arnau E, Martínez-Molina A, Barrós-Loscertales A. Structural cerebellar and lateral frontoparietal networks are altered in cannabis use disorder: an SBM analysis. Addict Biol. 2025;30(3):e70021. https://doi.org/10.1111/adb.70021. PMID:40072344; PMCID:PMC11899759.
- Wassmer E, Davies P, Whitehouse WP, Green SH. Clinical spectrum associated with cerebellar hypoplasia. Pediatr Neurol. 2003;28(5):347–351. https://doi.org/10.1016/S0887-8994(03)00016-X. PMID:12878295.
- Ocampo-Navia MI, Perez-Mendez W, Rodriguez-Alvarez MP, Chadid-Contreras J, Vergara MF. Dandy–Walker syndrome: an updated literature review. Childs Nerv Syst. 2025;41(1):194. https://doi.org/10.1007/s00381-025-06842-0. PMID:40445443; PMCID:PMC12125060.
- Zhao D, Liu W, Cai A, Li J, Chen L, Wang B. Quantitative evaluation of the fetal cerebellar vermis using the median view on three-dimensional ultrasound. Prenat Diagn. 2013;33(2):153–157. https://doi.org/10.1002/pd.4027. Epub 2012 Dec 13. PMID:23238967.
- Hendler I, Blackwell SC, Bujold E, Treadwell MC, Wolfe HM, Sokol RJ, Sorokin Y. The impact of maternal obesity on midtrimester sonographic visualization of fetal cardiac and craniospinal structures. Int J Obes Relat Metab Disord. 2004;28(12):1607–1611. https://doi.org/10.1038/sj.ijo.0802759. PMID:15303105
References
Pertl B, Eder S, Stern C, Verheyen S. The fetal posterior fossa on prenatal ultrasound imaging: normal longitudinal development and posterior fossa anomalies. Ultraschall Med. 2019;40(6):692–721. English. https://doi.org/10.1055/a-1015-0157. Epub 2019 Dec 3. PMID:31794996.
Alsehli H, Alshahrani SM, Alzahrani S, Ababneh F, Alharbi NM, Alarfaj N, Baarmah D. Fetal and neonatal outcomes of posterior fossa anomalies: a retrospective cohort study. Sci Rep. 2024;14(1):8411. https:10.1038/s41598-024-59163-8. PMID:38600369; PMCID:PMC11006671.
Bavini S, Mittal R, Mendiratta SL. Ultrasonographic measurement of the transcerebellar diameter for gestational age estimation in the third trimester. J Ultrasound. 2022;25(2):281–287. https://doi.org/10.1007/s40477-021-00564-0. Epub 2021 Mar 9. PMID:33687690; PMCID:PMC9148337.
de Barros FS, Bussamra LC, Araujo Júnior E, de Freitas LS, Nardozza LM, Moron AF, Aldrighi JM. Comparison of fetal cerebellum and cisterna magna length by 2D and 3D ultrasonography between 18 and 24 weeks of pregnancy. ISRN Obstet Gynecol. 2012;2012:286141. https://doi.org/10.5402/2012/286141. Epub 2012 Nov 14. PMID:23209923; PMCID:PMC3504390.
Spinelli M, Sica C, Meglio L, Bolla D, Raio L, Surbek D. Fetal cerebellar vermis circumference measured by two-dimensional ultrasound scan: reference range, feasibility and reproducibility. Ultrasound Int Open. 2016;2(4):E124–E128. https://doi.org/10.1055/s-0042-119952.
Reece EA, Goldstein I, Pilu G, Hobbins JC. Fetal cerebellar growth unaffected by intrauterine growth retardation: a new parameter for prenatal diagnosis. Am J Obstet Gynecol. 1987;157(3):632–638. https://doi.org/10.1016/S0002-9378(87)80019-4. PMID:3307422.
Pickut BA, Dierckx RA, Dobbeleir A, Audenaert K, Van Laere K, Vervaet A, De Deyn PP. Validation of the cerebellum as a reference region for SPECT quantification in patients suffering from dementia of the Alzheimer type. Psychiatry Res. 1999;90(2):103–112. https://doi.org/10.1016/S0925-4927(99)00004-9. PMID:10482382.
Scott JA, Hamzelou KS, Rajagopalan V, Habas PA, Kim K, Barkovich AJ, Glenn OA, Studholme C. Three-dimensional morphometric analysis of human fetal cerebellar development. Cerebellum. 2012;11(3):761–770. https://doi.org/10.1007/s12311-011-0338-2. PMID:22198870; PMCID:PMC3389138.
Wu KH, Chen CY, Shen EY. Cerebellar development in Chinese children: a study using voxel-based volume measurement of reconstructed 3D MRI scans. Pediatr Res. 2011;69(1):80–83. https://doi.org/10.1203/PDR.0b013e3181ff2f6c. PMID:20924316.
Gasperini C, Rovaris M, Sormani MP, Bastianello S, Pozzilli C, Comi G, et al. Intra-observer, inter-observer and inter-scanner variations in brain MRI volume measurements in multiple sclerosis. Mult Scler. 2001;7(1):27–31. https://doi.org/10.1177/135245850100700106.
Lacomba-Arnau E, Martínez-Molina A, Barrós-Loscertales A. Structural cerebellar and lateral frontoparietal networks are altered in cannabis use disorder: an SBM analysis. Addict Biol. 2025;30(3):e70021. https://doi.org/10.1111/adb.70021. PMID:40072344; PMCID:PMC11899759.
Wassmer E, Davies P, Whitehouse WP, Green SH. Clinical spectrum associated with cerebellar hypoplasia. Pediatr Neurol. 2003;28(5):347–351. https://doi.org/10.1016/S0887-8994(03)00016-X. PMID:12878295.
Ocampo-Navia MI, Perez-Mendez W, Rodriguez-Alvarez MP, Chadid-Contreras J, Vergara MF. Dandy–Walker syndrome: an updated literature review. Childs Nerv Syst. 2025;41(1):194. https://doi.org/10.1007/s00381-025-06842-0. PMID:40445443; PMCID:PMC12125060.
Zhao D, Liu W, Cai A, Li J, Chen L, Wang B. Quantitative evaluation of the fetal cerebellar vermis using the median view on three-dimensional ultrasound. Prenat Diagn. 2013;33(2):153–157. https://doi.org/10.1002/pd.4027. Epub 2012 Dec 13. PMID:23238967.
Hendler I, Blackwell SC, Bujold E, Treadwell MC, Wolfe HM, Sokol RJ, Sorokin Y. The impact of maternal obesity on midtrimester sonographic visualization of fetal cardiac and craniospinal structures. Int J Obes Relat Metab Disord. 2004;28(12):1607–1611. https://doi.org/10.1038/sj.ijo.0802759. PMID:15303105