Journals / Anatolian Current Medical Journal / 2026 / Volume: 8 Issue: 5

Reference centiles for fetal thymus transverse diameter at 18-25 weeks of gestation: a cross-sectional ultrasound study

Ayşe Ceren Duymuş(SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-8760-3781
Nizamettin Bozbay(SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-9632-5093
Rrezearta Cungu(SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0004-4299-1321
Osman Yıldırım(SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0001-3082-9704
Aybike Tazegül Pekin(SELÇUK ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0002-6399-0166
Pages
—
Publication Date
2026-09-11
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These data may facilitate standardized assessment of fetal thymus size, potentially contributing to the identification of fetuses at risk for genetic, inflammatory, or stress-related conditions.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: To establish gestational age-specific reference centiles for fetal thymus transverse diameter between 18 and 25 weeks of gestation, corresponding to the routine mid-trimester anatomical survey.
📊
Key Findings & Data:Methods: This retrospective cross-sectional study included singleton pregnancies that underwent detailed second-trimester ultrasonography between May 2023 and March 2025.
💡
Conclusion & Impact:These data may facilitate standardized assessment of fetal thymus size, potentially contributing to the identification of fetuses at risk for genetic, inflammatory, or stress-related conditions.
🔬Design:Survey & Empirical Study
📍Scope:2023 Verileri
⚙️Variables:Thymus · nomogram · prenatal care

Abstract

Aims: To establish gestational age-specific reference centiles for fetal thymus transverse diameter between 18 and 25 weeks of gestation, corresponding to the routine mid-trimester anatomical survey. Methods: This retrospective cross-sectional study included singleton pregnancies that underwent detailed second-trimester ultrasonography between May 2023 and March 2025. Fetal thymus images were retrieved from the institutional Picture Archiving and Communication System (PACS). Cases with structural or chromosomal anomalies, maternal systemic disease, multiple gestations, incomplete thymus imaging, or absent postnatal follow-up were excluded. The transverse diameter of the fetal thymus was measured in the three-vessel and trachea view by two maternal-fetal medicine specialists. Intraclass correlation coefficient (ICC) analysis was performed to assess interobserver agreement. The relationship between gestational age and thymus size was evaluated using Pearson correlation and linear regression. Gestational age-specific centiles were constructed. Results: A total of 407 fetuses between 18 and 25 weeks of gestation were included. Fetal thymus transverse diameter demonstrated a significant positive correlation with gestational age (r=0.567, p<0.001). Linear regression analysis showed that gestational age independently predicted thymus size (B=0.90 mm/week, p<0.001), explaining 32.1% of the variability (R²=0.321). Conclusion: We present gestational age-specific reference centiles for fetal thymus transverse diameter during routine mid trimester anatomical screening. These data may facilitate standardized assessment of fetal thymus size, potentially contributing to the identification of fetuses at risk for genetic, inflammatory, or stress-related conditions.

🔖

Cite This Article

Duymuş, A. C., Bozbay, N., Bozbay, Ö. P., Cungu, R., Yıldırım, O., Pekin, A. T. (2026). Reference centiles for fetal thymus transverse diameter at 18-25 weeks of gestation: a cross-sectional ultrasound study. Anatolian Current Medical Journal, Volume: 8 Issue: 5. https://doi.org/10.38053/acmj.1905446

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (24)

  1. Ciofani M, Zúñiga-Pflücker JC. The thymus as an inductive site for T lymphopoiesis. Annu Rev Cell Dev Biol. 2007;23:463-493. doi:10.1146/annurev.cellbio.23.090506.123547
  2. Perez YE, Moran CA. The thymus: general concepts on embryology, anatomy, histology and immunohistochemistry. Semin Diagn Pathol. 2022;39(2):86-91. doi:10.1053/j.semdp.2021.06.003
  3. Asghar A, Asad MR, Naaz S, Rani M. Screening of the growth of thymus of human fetuses. Anat Cell Biol. 2019;52(4):478-485. doi:10.5115/acb.19.094
  4. Foschi R, Rinaldi P, Meduri A, Campioni P, Pirronti T. Diagnostic imaging and therapy in a case of myasthenia gravis associated with thymic hyperplasia. Rays. 2003;28(4):369-378.
  5. Dou Y, Schindewolf E, Crowley TB, et al. The association of fetal thymus size with subsequent T cell counts in 22q11.2 deletion syndrome. J Clin Immunol. 2020;40(5):783-785. doi:10.1007/s10875-020-00807-5
  6. 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(6): 546-552. doi:10.1046/j.1469-0705.2002.00864.x
  7. De Leon-Luis J, Santolaya J, Gamez F, Pintado P, Perez R, Ortiz-Quintana L. Sonographic thymic measurements in Down syndrome fetuses. Prenat Diagn. 2011;31(9):841-845. doi:10.1002/pd.2783
  8. Rosa RF, Rosa RC, Zen PR, Graziadio C, Paskulin GA. Trisomy 18: review of the clinical, etiologic, prognostic, and ethical aspects. Rev Paul Pediatr. 2013;31(1):111-120. doi:10.1590/s0103-05822013000100018
  9. 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. 2020;33(7):1157-1161. doi:10.1080/14767058.2018.1517309
  10. Erol SA, Kulhan NG, Günenc O. Evaluation of fetal thymus size in pregnancies complicated with fetal growth restriction. J Gynecol Obstet Neonat. 2023;20(1):1617-1624. doi:10.38136/jgon.1195083
  11. Ayhan SG, Oluklu D, Sinaci S, et al. Fetal thymus size in pregnant women with COVID-19 infection. Gynecol Obstet Reprod Med. 2021;27(2):84-88. doi:10.21613/GORM.2021.1222
  12. Hu M, Eviston D, Hsu P, et al. Decreased maternal serum acetate and impaired fetal thymic and regulatory T cell development in preeclampsia. Nat Commun. 2019;10(1):3031. doi:10.1038/s41467-019-10703-1
  13. 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: nomogram and review of the literature. J Ultrasound Med. 2015;34(5):853-858. doi:10.7863/ultra.34.5.853
  14. Zych-Krekora K, Krekora M, Słodki M, et al. Nomograms of the fetal thymus for clinical practice. Arch Med Sci. 2019;17(6):1657-1662. doi:10.5114/aoms.2019.86189
  15. Tangshewinsirikul C, Panburana P. Sonographic measurement of fetal thymus size in uncomplicated singleton pregnancies. J Clin Ultrasound. 2017;45(3):150-159. doi:10.1002/jcu.22419
  16. Salomon LJ, Alfirevic Z, Berghella V, et al. ISUOG Practice Guidelines (updated): performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol. 2022;59(6):840-856. doi:10.1002/uog.24888
  17. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Doğum Öncesi Bakım Yönetim Rehberi. T.C. Sağlık Bakanlığı; 2024.
  18. 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(6):634-638. doi:10.1002/uog.3979
  19. Musilova I, Kacerovsky M, Reslova T, Tosner J. Ultrasound measurements of the transverse diameter of the fetal thymus in uncomplicated singleton pregnancies. Neuro Endocrinol Lett. 2010;31(6):766-770.
  20. Zalel Y, Gamzu R, Mashiach S, Achiron R. The development of the fetal thymus: an in utero sonographic evaluation. Prenat Diagn. 2002;22(2): 114-117. doi:10.1002/pd.257
  21. Rzhaninova AA, Gornostaeva SN, Goldshtein DV. Isolation and phenotypical characterization of mesenchymal stem cells from human fetal thymus. Bull Exp Biol Med. 2005;139(1):134-140. doi:10.1007/s10517-005-0231-4
  22. Yinon Y, Zalel Y, Weisz B, et al. Fetal thymus size as a predictor of chorioamnionitis in women with preterm premature rupture of membranes. Ultrasound Obstet Gynecol. 2007;29(6):639-643. doi:10.1002/uog.4022
  23. Gök K, Ozden S. Ultrasonographic evaluation of the fetal thymic-thoracic ratio in preeclampsia. J Matern Fetal Neonatal Med. 2023;36(1): 2183739. doi:10.1080/14767058.2023.2183739
  24. Caissutti C, Familiari A, Khalil A, et al. Small fetal thymus and adverse obstetrical outcome: a systematic review and a meta-analysis. Acta Obstet Gynecol Scand. 2018;97(2):111-121. doi:10.1111/aogs.13249