Measurement of fetal liver, brain and placental volumes with echo-planar magnetic resonance imaging.

OBJECTIVE: To quantify accurately in utero fetal liver, brain and placental volumes using echo planar imaging, and to assess whether the technique has the potential to enhance intrauterine fetal assessment.
DESIGN: Thirty-two singleton, complicated pregnancies were scanned using echo planar imaging, a form of magnetic resonance imaging. Pregnancies were subdivided on the basis of whether the fetus was found subsequently to have an individualised birthweight ratio above (n = 21) or below (n = 11) the 10th centile. Comparisons of the organ volumes of these two groups were made.
RESULTS: The first quantitative in utero measurement of fetal liver volume showed a linear relation between liver volume and gestational age in fetuses where the individualised birthweight ratio was above the 10th centile (the normal growth group). Ten of the 11 liver volume measurements of fetuses subsequently found to have an individualised birthweight ratio below the 10th centile fell on or outside the 95% confidence limits established for the normal growth group. In contrast, no such differences were demonstrated when the brain and placental volumes were considered, with 10 of the 11 brain measurements and all of the 11 placental measurements falling within the 95% confidence limits of the normal growth group.
CONCLUSIONS: A single measurement of fetal liver volume using echo planar imaging enabled accurate identification of fetuses subsequently found to have individualised birthweight ratios below the 10th centile. If these findings are repeated in larger, more representative studies, this suggests that the technique has the potential to contribute to intrauterine fetal assessment.