Objective This study aims to evaluate the accuracy of magnetic resonance imaging (MRI) in diagnosing orofacial clefts and proposes specific signs for determining the type of cleft. Methods Pregnant women in whom fetal facial malformations are suspected by ultrasonography (US) underwent 1.5 T MRI. The accuracy of the prenatal US and MRI diagnosis was compared with the postnatal findings. Results A total of 71 fetuses were included in the final analysis, which comprised of 35 cases of isolated cleft lip, six cases of cleft lip and alveolus, 21 cases of cleft lip and palate, four cases of isolated cleft palate, and five normal fetuses. MRI was more sensitive than US (MRI 100%, US 77.5%; Fisher's exact test: MRI vs US P=0.000). The accuracy of MRI for all types was 100%. Specific signs (Inverted T, L/anti‐L, U, and “Notch” signs) were proposed, indicating the normal hard, unilateral cleft, bilateral cleft, and cleft soft palates, respectively, which can facilitate the identification of different types of cleft palates. Conclusion MRI can accurately diagnose the type of cleft based on typical signs, which can serve as a definite diagnostic modality and an effective supplement of US.

Objective: Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. This study aims to characterize normal spinal growth in human fetuses during the second and third trimesters.Methods: Postmortem 3.0 T magnetic resonance imaging (MRI) was performed on 55 fetuses at 17-42 gestational weeks by using three-dimensional T2-weighted sequences. Morphological changes and quantitative measurements of the fetal spine were assessed. The correlation between centrum ossification center volume (COCV) and gestational age was investigated. Results:The cervical, thoracic, and lumbar COCVs showed a positive relationship with gestational age (p < 0.05). No gender differences were found in the volumetric development of the cervical, thoracic, and lumbar centrum ossification centers (COCs). The average volumetric growth rate per COC was larger in the lumbar spine than in the cervical and thoracic spine. The L1-L5 COCVs also showed a linear positive relationship with gestational age.Consults: Postmortem 3.0 T MRI clearly demonstrated spinal changes in external contour and internal structure with gestational age. These findings expand our understanding of the early growth pattern of the human spine and could be further used to assess the developmental conditions of the fetal spine. Key pointsWhat's already known about this topic? � Before evaluating spinal pathology, it is essential to have knowledge of the normal spinal development at different gestational ages. � Many different measurements have been used to assess the spinal development on fetal computed tomography and ultrasound, but not comprehensively.Shuai Zhang and Xianshun Yuan contributed equally to this work and should be considered co-first authors. Xiangtao Lin and Ximing Wang contributed equally to this work and should be considered co-corresponding authors.

We have presented the timing of appearance of individual sacrococcygeal COCs and the age-specific, normative MRI reference values for sacral length and the morphometric parameters of the sacral COCs, which are of clinical importance in the diagnosis of congenital sacral abnormalities and skeletal dysplasia.

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