Thymic–thoracic ratio in fetuses with trisomy 21, 18 or 13
Open accessAbstract
Objectives: To assess thymic size expressed as the thymic–thoracic ratio (TT‐ratio) in fetuses with trisomy 21, 18 or 13. Methods: The TT‐ratio, the quotient of the anteroposterior thymic and the intrathoracic mediastinal diameter, was measured in 65 trisomic fetuses between 15 and 36 weeks' gestation, including 30 cases with trisomy 21, 19 with trisomy 18 and 16 with trisomy 13. In addition these 65 fetuses were divided into two groups, according to whether they showed growth that was appropriate‐for‐gestational age (AGA) (n = 39) or intrauterine growth restriction (IUGR) (n = 26). Measurements were compared with reference ranges from 302 normal fetuses. Results: The TT‐ratio was low in 27.7% (n = 18) of the 65 fetuses with aneuploidy. In comparison to normal fetuses (mean TT‐ratio, 0.44), those with trisomy 18 or 21 had a significantly smaller TT‐ratio (mean, 0.38 (P < 0.001) and 0.40 (P < 0.05), respectively), while those with trisomy 13 did not (mean, 0.43). These values were not as low as those observed previously in fetuses with del.22q11, suggesting a mechanism involving accelerated thymic involution rather than primary thymic hypoplasia. Furthermore, the TT‐ratio was significantly lower than normal in both AGA (P < 0.05) and IUGR (P < 0.001) fetuses. Conclusion: Fetuses with trisomy 18 or 21, but not trisomy 13, have a small thymus, suggesting accelerated thymic involution in utero. IUGR may contribute to the reduced thymic size in trisomy 18 fetuses. Trisomy 21 fetuses seem to have additional factors leading to a small thymus which could be a possible confirmation of the reduced immune response observed in fetuses and neonates with Down syndrome. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
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The three-vessel view and closely related three-vessels-and-trachea view may improve detection of outflow tract, aortic arch and systemic vein anomalies.
“The three-vessel view and closely related three-vessels-and-trachea view may improve detection of outflow tract, aortic arch and systemic vein anomalies (Figure 4d,e) 73-77 .”
From <scp>ISUOG</scp> Practice Guidelines (updated): performance of the routine mid‐trimester fetal ultrasound scan (2022) · cites this paper as [74]
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- Authors
- Karl, K., Heling, K. ‐., Sarut Lopez, A., Thiel, G., & Chaoui, R.
- Affiliations
- Ludwig-Maximilians-Universität München (DE)
- Corresponding author
- Chaoui, R.
- ORCID
- Venue
- Ultrasound in Obstetrics & Gynecology
- Publisher
- Wiley
- Published
- 2012-09-25
- Volume
- 40
- Issue
- 4
- Pages
- 412-417
- ISSN
- 0960-7692 (ISSN-L)
- 1469-0705
- OpenAlex
- W2039853301
- Cited by
- 48
- References
- 26
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 9 · 2022: 2 · 2021: 6 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 4 · 2015: 5 · 2014: 3 · 2013: 2
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Ultrasound in Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Surgery › Congenital Anomalies and Fetal Surgery
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
- Keywords
- fetal thymus, Down syndrome, trisomy 18, trisomy 13, fetal growth restriction, thymic involution, thymic hypoplasia, fetal aneuploidy, fetal immune response, prenatal diagnosis
- MeSH terms
- Trisomy 13 Syndrome, Adult, Chromosomes, Human, Pair 13, Chromosomes, Human, Pair 18, Down Syndrome, Female, Fetal Growth Retardation, Gestational Age, Humans, Male, Organ Size, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Thorax, Thymus Gland, Trisomy, Ultrasonography, Prenatal, Chromosome Disorders
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