Yıl: 2022 Cilt: 30 Sayı: 1 Sayfa Aralığı: 66 - 74 Metin Dili: İngilizce DOI: 10.2399/prn.22.0301014 İndeks Tarihi: 17-06-2022

Fetal thymus reference range in healthy singleton pregnancies

Öz:
Objective: To present the reference range of the fetal thymus gland according to gestational age groups. Methods: In this prospective study, fetal thymus size was assessed in singleton, uncomplicated pregnancies between 19 and 38 weeks of gestation in our outpatient clinic between 2019 and 2020. Based on their monthly pregnancy follow-ups, fetal thymus measurement was divided into 5 gestational age groups (Group 1: 19–22 weeks, Group 2: 23–26 weeks, Group 3: 27–30 weeks, Group 4: 31–34 weeks, and Group 5: 35–38 weeks). Results: Fetal thymus measurements of 210 patients were performed over one year, and as a result, 184 pregnant patients were included for assessment. Fetal thymus could be visualized at a rate of 93.5%. The 5th percentile of thymus transverse diameter, antero-posterior diameter, perimeter, thymus anterior-posterior diameter to thoracic diameter, and thymus perimeter to thoracic circumference were 11.03 mm, 5.60 mm, 32.52 mm, 0.33, and 0.32 in Group 1; 13.53 mm, 7.66 mm, 43.67 mm, 0.34, and 0.32 in Group 2; 20.43 mm, 11.22 mm, 47.72 mm, 0.33, and 0.32 in Group 3; 27 mm, 12.98 mm, 55.88 mm, 0.32, and 0.30 in Group 4; 28 mm, 13.59 mm, 63.4 mm, 0.32, and 0.30 in Group 5; respectively. Spearman’s rho correlation coefficients for the thymic measurements were 0.879, 0.869, 0.846, 0.236, and 0.267 respectively, and all p-values were less than 0.001. As a result of linear regression analysis between thymus measurements and BPD; the equations for the optimal models are as follows: thymus transverse diameter= -3.49+0.4×BPD (mm) (r=0.826, R2 =0.682, p<0.001), thymus anterior-posterior diameter= -2.48+0.22×BPD (mm) (r=0.808, R2 =0.653, p<0.001), thymus perimeter= -14.37+1.21×BPD (mm) (r=0.814, R2 =0.663, p<0.001), thymus anterior-posterior diameter /thoracic diameter= 0.38+7.76E-4×BPD (r=0.213, R2 =0.045, p=0.004) and thymus perimeter/thoracic circumference= 0.35+1.02E-3×BPD (r=0.263, R2 =0.069, p<0.001). Thymus transverse diameter, anterior-posterior diameter, and perimeter increased linearly with increasing biparietal diameter (BPD). Conclusion: We established the reference ranges of fetal thymus size. Thymus transverse diameter, antero-posterior diameter, and thymus perimeter have a strong relationship with gestational age and are easy and reproducible. Therefore, the knowledge of reference ranges of fetal thymus will enable the evaluation of thymic aplasia/hypoplasia
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Cho JY, Min JY, Lee YH, McCrindle B, Hornberger LK, Yoo SJ. Diameter of the normal fetal thymus on ultrasound. Ultrasound Obstet Gynecol 2007;29:634–8. [PubMed] [CrossRef]
  • 2. Gamez F, De Leon-Luis J, Pintado P, Perez R, Robinson JN, Antolin E, et al. Fetal thymus size in uncomplicated twin and singleton pregnancies. Ultrasound Obstet Gynecol 2010;36: 302–7. [PubMed] [CrossRef]
  • 3. Chaoui R, Kalache KD, Heling KS, Tennstedt C, Bommer C, Körner H. Absent or hypoplastic thymus on ultrasound: a marker for deletion 22q11.2 in fetal cardiac defects. Ultrasound Obstet Gynecol 2002;20:546–52. [PubMed] [CrossRef]
  • 4. Thomas JA, Graham JM. Chromosome 22q1l deletion syndrome: an update and review for the primary pediatrician. Clin Pediatr (Phila) 2016;36:253–66. [PubMed] [CrossRef]
  • 5. Zalel Y, Gamzu R, Mashiach S, Achiron R. The development of the fetal thymus: an in utero sonographic evaluation. Prenat Diagn 2002;22:114–7. [PubMed] [CrossRef]
  • 6. Aksakal SE, Kandemir O, Alt›nbas S, Esin S, Müftüoglu KH. Fetal tyhmus size as a predictor of histological chorioamnionitis in preterm premature rupture of membranes. J Matern Fetal Neonatal Med 2013;27:1118–22. [PubMed] [CrossRef]
  • 7. Ghalandarpoor-Attar SN, Borna S, Ghalandarpoor-Attar SM, Hantoushzadeh S, Khezerdoost S, Ghotbizadeh F. Measuring fetal thymus size: a new method for diabetes screening in pregnancy. J Matern Fetal Neonatal Med 2018;33:1157– 61. [PubMed] [CrossRef]
  • 8. Muñoz-Chápuli M, Gámez F, Bravo C, Ortiz L, Pérez R, De León-Luis JA. The thy-box for sonographic assessment of the fetal thymus. J Ultrasound Med 2015;34:853–8. [PubMed] [CrossRef]
  • 9. Tangshewinsirikul C, Panburana P. Sonographic measurement of fetal thymus size in uncomplicated singleton pregnancies. J Clin Ultrasound 2017;45:150–9. [PubMed] [CrossRef]
  • 10. Yagel S, Arbel R, Anteby EY, Raveh D, Achiron R. The three vessels and trachea view (3VT) in fetal cardiac scanning. Ultrasound Obstet Gynecol 2002;20:340–5. [PubMed] [CrossRef]
  • 11. Gill J, Malin M, Sutherland J, Gray D, Hollander G, Boyd R. Thymic generation and regeneration. Immunol Rev 2003;195: 28–50. [PubMed] [CrossRef]
  • 12. Nau TG, de Murcia KO, Möllers M, Braun J, Abhari RE, Steinhard J, et al. Foetal thymus size in pregnancies after assisted reproductive technologies. Arch Gynecol Obstet 2018;298: 329–36. [PubMed] [CrossRef]
  • 13. Ekin A, Gezer C, Taner CE, Solmaz U, Gezer NS, Ozeren M. Prognostic value of fetal thymus size in intrauterine growth restriction. J Ultrasound Med 2016;35:511–7. [PubMed] [CrossRef]
  • 14. Pittyanont S, Luewan S, Tongsong T. Cardio-STIC based reference ranges of fetal thymus size in singleton pregnancies. J Ultrasound Med 2017;36:1181–8. [PubMed] [CrossRef]
  • 15. Dörnemann R, Koch R, Möllmann U, Falkenberg MK, Möllers M, Klockenbusch W, et al. Fetal thymus size in pregnant women with diabetic diseases. J Perinat Med 2017;45: 595–601. [PubMed] [CrossRef]
  • 16. Chaoui R, Heling KS, Sarut Lopez A, Thiel G, Karl K. The thymic-thoracic ratio in fetal heart defects: a simple way to identify fetuses at high risk for microdeletion 22q11. Ultrasound Obstet Gynecol 2011;37:397–403. [PubMed] [CrossRef]
  • 17. Asghar A, Asad MR, Naaz S, Rani M. Screening of the growth of thymus of human fetuses. Anat Cell Biol 2019;52:478–85. [PubMed] [CrossRef]
  • 18. Felker RE, Cartier MS, Emerson DS, Brown DL. Ultrasound of the fetal thymus. J Ultrasound Med 1989;8:669–73. [PubMed] [CrossRef]
  • 19. Borgelt JMA, Möllers M, Falkenberg MK, Amler S, Klockenbusch W, Schmitz R. Assessment of first-trimester thymus size and correlation with maternal diseases and fetal outcome. Acta Obstet Gynecolog Scand 2016;95:210–6. [PubMed] [CrossRef]
  • 20. Kleemann S, Koch R, Schmitz R, Köster HA, Braun J, Steinhard J, et al. Correlation of first-trimester thymus size with chromosomal anomalies. J Perinat Med 2021;49:604–13. [PubMed] [CrossRef]
  • 21. Tonni G, Rosignoli L, Cariati E, Martins WP, Miyague AH, Bruns RF, et al. Fetal thymus: visualization rate and volume by integrating 2D- and 3D-ultrasound during 2nd trimester echocardiography. J Maternal Fetal Neonatal Med 2015;29: 2223–8. [PubMed] [CrossRef]
  • 22. Yildirim M, Ipek A, Dauletkazin G, Cendek BD, Gezegen S, Desdicioglu R, et al. Sonographic measurement of the fetal thymus: relationship with maternal obesity. J Clin Ultrasound 2017;45:277–81. [PubMed] [CrossRef]
  • 23. Musilova I, Hornychova H, Kostal M, Jacobsson B, Kacerovsky M. Ultrasound measurement of the transverse diameter of the fetal thymus in pregnancies complicated by the preterm prelabor rupture of membranes. J Clin Ultrasound 2013;41:283–9. [PubMed] [CrossRef]
APA Yılmaz Baran Ş, Doğan Durdağ G, Aydın Ş, ALKAŞ YAĞINÇ D, Alemdaroglu S, Cok T, KALAYCI H (2022). Fetal thymus reference range in healthy singleton pregnancies. , 66 - 74. 10.2399/prn.22.0301014
Chicago Yılmaz Baran Şafak,Doğan Durdağ Gülşen,Aydın Şirin,ALKAŞ YAĞINÇ DİDEM,Alemdaroglu Songul,Cok Tayfun,KALAYCI HAKAN Fetal thymus reference range in healthy singleton pregnancies. (2022): 66 - 74. 10.2399/prn.22.0301014
MLA Yılmaz Baran Şafak,Doğan Durdağ Gülşen,Aydın Şirin,ALKAŞ YAĞINÇ DİDEM,Alemdaroglu Songul,Cok Tayfun,KALAYCI HAKAN Fetal thymus reference range in healthy singleton pregnancies. , 2022, ss.66 - 74. 10.2399/prn.22.0301014
AMA Yılmaz Baran Ş,Doğan Durdağ G,Aydın Ş,ALKAŞ YAĞINÇ D,Alemdaroglu S,Cok T,KALAYCI H Fetal thymus reference range in healthy singleton pregnancies. . 2022; 66 - 74. 10.2399/prn.22.0301014
Vancouver Yılmaz Baran Ş,Doğan Durdağ G,Aydın Ş,ALKAŞ YAĞINÇ D,Alemdaroglu S,Cok T,KALAYCI H Fetal thymus reference range in healthy singleton pregnancies. . 2022; 66 - 74. 10.2399/prn.22.0301014
IEEE Yılmaz Baran Ş,Doğan Durdağ G,Aydın Ş,ALKAŞ YAĞINÇ D,Alemdaroglu S,Cok T,KALAYCI H "Fetal thymus reference range in healthy singleton pregnancies." , ss.66 - 74, 2022. 10.2399/prn.22.0301014
ISNAD Yılmaz Baran, Şafak vd. "Fetal thymus reference range in healthy singleton pregnancies". (2022), 66-74. https://doi.org/10.2399/prn.22.0301014
APA Yılmaz Baran Ş, Doğan Durdağ G, Aydın Ş, ALKAŞ YAĞINÇ D, Alemdaroglu S, Cok T, KALAYCI H (2022). Fetal thymus reference range in healthy singleton pregnancies. Perinatal journal (Online), 30(1), 66 - 74. 10.2399/prn.22.0301014
Chicago Yılmaz Baran Şafak,Doğan Durdağ Gülşen,Aydın Şirin,ALKAŞ YAĞINÇ DİDEM,Alemdaroglu Songul,Cok Tayfun,KALAYCI HAKAN Fetal thymus reference range in healthy singleton pregnancies. Perinatal journal (Online) 30, no.1 (2022): 66 - 74. 10.2399/prn.22.0301014
MLA Yılmaz Baran Şafak,Doğan Durdağ Gülşen,Aydın Şirin,ALKAŞ YAĞINÇ DİDEM,Alemdaroglu Songul,Cok Tayfun,KALAYCI HAKAN Fetal thymus reference range in healthy singleton pregnancies. Perinatal journal (Online), vol.30, no.1, 2022, ss.66 - 74. 10.2399/prn.22.0301014
AMA Yılmaz Baran Ş,Doğan Durdağ G,Aydın Ş,ALKAŞ YAĞINÇ D,Alemdaroglu S,Cok T,KALAYCI H Fetal thymus reference range in healthy singleton pregnancies. Perinatal journal (Online). 2022; 30(1): 66 - 74. 10.2399/prn.22.0301014
Vancouver Yılmaz Baran Ş,Doğan Durdağ G,Aydın Ş,ALKAŞ YAĞINÇ D,Alemdaroglu S,Cok T,KALAYCI H Fetal thymus reference range in healthy singleton pregnancies. Perinatal journal (Online). 2022; 30(1): 66 - 74. 10.2399/prn.22.0301014
IEEE Yılmaz Baran Ş,Doğan Durdağ G,Aydın Ş,ALKAŞ YAĞINÇ D,Alemdaroglu S,Cok T,KALAYCI H "Fetal thymus reference range in healthy singleton pregnancies." Perinatal journal (Online), 30, ss.66 - 74, 2022. 10.2399/prn.22.0301014
ISNAD Yılmaz Baran, Şafak vd. "Fetal thymus reference range in healthy singleton pregnancies". Perinatal journal (Online) 30/1 (2022), 66-74. https://doi.org/10.2399/prn.22.0301014