Discrepancy in fetal head biometry between ultrasound and MRI in suspected microcephalic fetuses

Gal Yaniv, Eldad Katorza, Vered Tsehmaister Abitbol, Arik Eisenkraft*, Ronen Bercovitz, Salim Bader, Chen Hoffmann

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Microcephaly is one of the most common fetal structural abnormalities, and prenatal microcephaly is considered a group I malformation of cortical development diagnosed according to ultrasound (US) skull measurements. Purpose: To evaluate the agreement between fetal head US and magnetic resonance imaging (MRI) biometric measurements of suspected microcephalic fetuses. Material and Methods: This institutional review board-approved retrospective study with waived informed consent included 180 pregnant women and was conducted at our medical center from March 2011 to April 2013. Biparietal diameter (BPD) and occipitofrontal diameter (OFD) results of fetal head US normograms were compared to normograms for MRI. We used Pearson and Spearman rho non-parametric correlation coefficients to assess the association between two quantitative variables, paired t-test for paired quantitative variables, and McNemar test for paired qualitative variables. Results: The average BPD but not the average OFD percentiles in fetal head US differed significantly from the MRI results (P < 0.0001). When looking at the accepted microcephaly threshold, both BPD and OFD percentiles differed significantly from MRI (P < 0.0001 and P < 0.004, respectively). There was no correlation between US-measured skull biometry and MRI-measured brain biometry. Estimated cerebrospinal fluid volumes were significantly lower in the study group compared to 120 fetuses with normal findings in prenatal head US and MRI. Also, we have created a MRI-based normogram of fetal head circumference and gestational age. Conclusion: The diagnosis of microcephaly by US alone may be insufficient and ideally should be validated by MRI before a final diagnosis is established.

Original languageEnglish
Pages (from-to)1519-1527
Number of pages9
JournalActa Radiologica
Issue number12
StatePublished - 1 Dec 2017


  • Ultrasound
  • biparietal diameter
  • magnetic resonance imaging (MRI)
  • microcephaly
  • normogram
  • occipitofrontal diameter


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