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Objective:To measure the morphological parameters of the fetal vertebral centrum ossification centers (COC) in the second-third trimester using MRI susceptibility weighted imaging (SWI), and to explore the growth and development trajectory of the vertebrae.Methods:Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021, and the SWI scanning of fetal spine was performed. The following morphometric parameters of the C4, T6, L3, S1 vertebrae COC were measured, including sagittal diameter, transverse diameter, height, cross-sectional area and volume. The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results:A total of 112 fetuses were recruited with gestatonal age 21-39 (29.4±3.9) weeks, including 30 cases of C4, 58 cases of T6, 92 cases of L3, 62 cases of S1. Fetal spine in utero with global curvature was kyphosis, presenting two primary curves (thoracic and sacral kyphosis). The morphological parameters sagittal diameter, transverse diameter, height, cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks (R 2=0.938, 0.943, 0.952, 0.957, 0.982). During 21 to 38 weeks, the sagittal diameter, transverse diameter and height of the T6 followed the exponential growth pattern (R 2=0.915, 0.923, 0.849) and the growth of the area and volume followed the quadratic polynomial growth pattern (R 2=0.943, 0.961). The L3 followed the quadratic polynomial rule during 21 to 39 weeks (R 2=0.910, 0.916, 0.914, 0.942, 0.948) The sagittal diameter, transverse diameter and height of the S1 followed the linear growth pattern (R 2=0.905, 0.911, 0.922) and the area and volume followed the quadratic polynomial growth pattern (R 2=0.930, 0.964) during 23 to 39 weeks. Conclusions:The growth and development of C4, T6, L3 and S1 COC of fetus in the second-third trimester has a good correlation with gestational age. The growth of fetal vertebral COC in the early stage is slow, but with the growth of gestational age, the growth rate of vertebral bodies accelerates.
ABSTRACT
La placa de crecimiento es una estructura que está conformada por células, denominadas condrocitos, que se ordenan en columnas y confieren el alargamiento del hueso debido a su proliferación e hipertrofia. En cada columna se pueden observar condrocitos en estado proliferativo (que se dividen constantemente), e hipertrófico (que crecen para obtener una forma casi esférica). Estas células expresan diferentes proteínas y moléculas a lo largo de su vida media y tienen un comportamiento especial que puede depender de su entorno local mecánico y bioquímico. En este artículo se desarrolla un modelo matemático que describe la relación entre la geometría, el crecimiento por proliferación e hipertrofia y la invasión vascular con los factores bioquímicos y mecánicos presentes durante el desarrollo endocondral
The growth plate is a structure composed of cells called chondrocytes arranged in columns and causing the bone lengthening due to its proliferation and hypertrophy. In each column it may observed the presence of chondrocytes in proliferation stage (constantly divided) and hypertrophy stage (growing to obtain a almost spherical shape). These cells express different proteins and molecules during half-life and have a special behavior that may to depend on its mechanical or biochemical local environment. In present paper it is developed a mathematical model describing the relationship among the geometry, proliferation and hypertrophy growth and the vascular invasion by biochemical and mechanical factors present during the endochondral development
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Radiographic research was performed to know the frequency of two-phalanged fifth toe and its relation to presence of the ossification centers in normal Korean children. Previous study showed more than 74% of the incidence in adulthood and less than 30% in childhood. Fifty children (33 male and 17 female, aged 2 to 15; mean age 9.6) were studied by plain foot radiographs focused on the fifth toe. In the 3~8 yr old 20 subjects, secondary ossification center of distal phalangeal bone was seen as a ossicle (small bone) placed at proximal to the distal phalanx. Secondary ossification center of middle phalangeal bone and the bony shaft of the phalanx was hard to distinguish. So keeping up the objectivity, regardless of distinguishable ossification center or the bony shaft of phalanges, ossicles seen on the 5th toe was counted to classify the presumptive type of the toe. Epiphyseal ossification center of proximal phalanx was excluded from the count. There were three types of the fifth toe which has 2 ossicles to 4 ossicles. Overall incidence of the type of 2 ossicles was 24% (12/50). Above 12 yr old group the incidence was 61% (11/18), and above 13 yr old group the incidence was 75% (9/12). The incidence of biphalangism came closer to the adult's after late childhood. This finding represent that progress of biphalangealization completed after late childhood. It seems that the progress starts earlier than 3 yr old. We made the hypothesis by the incidence of 30% (6/20) of the type which has 4 ossicles on the fifth toe at 3~8 yr old group. Four ossicles might be a secondary ossification center of distal phalanx and the bony shaft of distal, middle and proximal phalanx. They might form a distal interphalageal joint and the triphalangeal toe. To know more about the morphogenesis of biphalalngeal 5th toe, further progressive study in childhood is needed.
Subject(s)
Child , Female , Humans , Male , Foot , Incidence , Joints , Morphogenesis , ToesABSTRACT
PURPOSE: Biochemical confirmation of congenital hypothyroidism takes about 10 days, which may result in a delay in diagnosis. The delay could be reduced if a faster method of investigation such as knee radiograph is used. The aim of this study is to assess the value of plain radiography of the knee in providing supportive evidence for the diagnosis of congenital hypothyroidism. METHODS: Neonates with a screening TSH over 20microunit/mL or free T4 under 0.85ng/dL were referred for further investigation during period of 1992-1998. We included 116 patients whose results were all available. Diagnosis was confirmed by measuring serum TSH, T4, free T4 by radioimmunoassay, radioisotope scan and ultrasonography of the thyroid. Radiography of the knee was obtained and ossification center sizes were measured. RESULTS: Among 116 neonates, 31 were normal and congenital hypothyroisism was confirmed in 85 neonates. There was a statistically significant difference between the controls and the patients in regards to both biochemical data and knee epiphyseal ossification center size. In the congenital hypothyroidism group, there were a significant difference in biochemical data and knee epiphyseal ossification center size according to the diagnosis, and significant correlation between biochemical data and knee ossification center size, especially with serum T4 and combined mean epiphyseal diameter(r=0.56, P<0.01). In the patient group, simple regression equation was made between biochemical data and knee ossification center size. Combined mean epiphyseal diameter(mm) was 0.544 T4+4.161, combined epiphyseal surface area(mm2) was 2.940 T4+14.283. If T4 is below 7 microgram/dL, combined mean epiphyseal diameter is below 8mm and surface area is below 34mm2. CONCLUSION: In neonates with abnormal thyroid screening, knee radiograph showing a combined mean epiphyseal diameter of 8mm or less and surface area of 34mm2 or less suggests congenital hypothyroidism prior to biochemical confirmation, requiring thyroxine treatment.