, Volume 61, Issue 2, pp 183–193 | Cite as

Normal development of costal element ossification centers of sacral vertebrae in the fetal spine: a postmortem magnetic resonance imaging study

  • Nan Jian
  • Nan Lin
  • Mi-Mi Tian
  • Shuai Zhang
  • Guan Li
  • Hui Zhao
  • Lian-Xiang Xiao
  • Wen-Jia Liang
  • Xiang-Tao LinEmail author
Paediatric Neuroradiology



This postmortem magnetic resonance imaging (MRI) study of the fetal spine aimed to describe the timing of appearance, shape, volume, and relative positions of the S1–S3 costal element ossification centers (CEOCs).


We obtained sagittal 3D dual-echo steady-state with water excitation T2 images of the entire spine in 71 fetuses (gestational ages (GAs), 17–42 weeks). Computed tomography and histological examinations were performed on two fetal specimens (GAs, 21 and 30 weeks) to validate the MR images. The presence/absence of each sacral CEOC was recorded according to the GA. CEOC volume was measured. We analyzed the CEOC position relative to the vertebral column and ilium.


The S1, S2, and S3 CEOCs first appeared at 23, 22, and 29 weeks, respectively. The S1 and S2 CEOCs could be detected in all fetuses with GAs of ≥ 30 weeks and ≥ 35 weeks, respectively, while the S3 CEOCs were variably present until term. The percentages of detection of the S1 and S2 CEOCs were significantly greater than that of the S3 CEOCs at each GA. At S1 and S2, the CEOC volume increased exponentially with GA. The relative positions of the S1 and S2 CEOCs, but not the S3 CEOCs, significantly correlated with GA (P < 0.001).


We have described the timeline of appearance as well as the volume and position of the S1–S3 CEOCs in the fetal spine on postmortem MRI according to GA.


Fetal spine Costal element ossification center Sacrum 



Costal element ossification center


Centrum ossification center


Neural arch ossification center


Gestational age


Intervertebral disc


Three-dimensional dual-echo steady-state with water excitation


Magnetic resonance imaging


Computed tomography


Compliance with ethical standards


This study was funded by the National Natural Science Foundation of China (Project Code: 31371213) and the Natural Science Foundation of Shandong Province, China (Project Code: ZR2013HM091).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Shandong University Ethics Committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

234_2018_2147_MOESM1_ESM.doc (28 kb)
ESM 1 (DOC 28.0 kb)
234_2018_2147_Fig8_ESM.png (421 kb)
Supplementary Fig. S1

Three-dimensional images obtained using the “ROI volume” tool in Osirix showing the a1d1 right and a2d2 left S1 costal element ossification centers in fetuses aged a1, a2 28, b1, b2 30, c1, c2 36, and d1, d2 39 weeks (PNG 420 kb)

234_2018_2147_MOESM2_ESM.tif (4.2 mb)
High Resolution Image (TIF 4345 kb)
234_2018_2147_MOESM3_ESM.docx (18 kb)
Supplementary Table S1 Distribution of the fetuses studied according to gestational age (GA) (DOCX 18 kb)
234_2018_2147_MOESM4_ESM.docx (15 kb)
Supplementary Table S2 Functions of relative positions (distance A and B) of S1 and S2 CEOCs (DOCX 15 kb)
234_2018_2147_MOESM5_ESM.docx (15 kb)
Supplementary Table S3 Multiple pairwise comparisons of the BA ratios at the S1, S2, and S3 vertebral levels for the left or right side. The statistical test selected depended on whether or not the difference between two ratios was normally distributed (DOCX 15 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of MedicineShandong UniversityJinanChina
  2. 2.CT DepartmentHeze Municipal HospitalHezeChina
  3. 3.Department of RadiologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanChina
  4. 4.College of RadiologyTaishan Medical UniversityTaianChina
  5. 5.Shandong Medical Imaging Research InstituteShandong UniversityJinanChina
  6. 6.School of Basic Medical ScienceShandong UniversityJinanChina

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