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Updated: May 6, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
A Novel Fetal Intracranial Measurement Contributing to the Differential Diagnosis of Fetal Microcephaly
Xi Du1,2,3,4,5,6, Rong Zhu7, HongJia Li8
1National Center for Healthcare Quality Management in Obstetrics, Beijing, China.
Objectives:
To evaluate the value of the thickness of the frontal lobe (TFL) and foramen magnum-to-cranium distance (FCD) for predicting poor neurodevelopmental outcomes in fetuses with a small head circumference (HC).
Methods:
This retrospective observational study included 39 fetuses with HC < -2 standard deviations (SD) and 592 prospectively collected controls with normal growth. TFL was defined as the shortest distance between the upper outer border of the corpus callosum and the upper inner cranial border parallel to the FCD. Reference ranges for FCD and TFL were established in 592 healthy fetuses between 21 and 38 weeks of gestation and applied to fetuses with suspected microcephaly. Diagnostic performance was assessed using sensitivity, specificity, and SD-based thresholds.
Results:
Normal reference ranges for FCD and TFL across gestation were established. All fetuses with normal postnatal outcomes had TFL values within the normal range, whereas reduced TFL was observed only in fetuses with poor neurodevelopmental outcomes. For predicting adverse outcomes, TFL <-2 SD showed a specificity of 100%, compared with 88% for FCD <-2 SD. Combining HC <-2 SD with TFL <-2 SD improved identification of fetuses with poor outcomes, including cases with borderline HC measurements (-2 to -3 SD).
Conclusions:
When combined with HC, reduced TFL may serve as a highly specific prenatal marker for identifying fetuses at risk for adverse neurodevelopmental outcomes in suspected microcephaly.
