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Three-dimensional US Assessment of Hepatic Volume, Head Circumference, and Abdominal Circumference in Healthy and Growth-restricted Fetuses¹

¹ From the Departments of Obstetrics and Gynaecology (S.M.E.B., J.A.M.L., P.C.S., J.W.W.) and Epidemiology and Biostatistics (T.S.), Erasmus University Medical Centre, University Hospital Rotterdam-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Received March 22, 2001; revision requested April 26; final revision received November 7; accepted December 5. Address correspondence to J.W.W. (e-mail: breur@gyna.azr.nl).

PURPOSE: To establish reproducibility and normal values for fetal hepatic volume and its significance in identification of fetal growth restriction relative to head and upper abdominal circumferences according to a cross-sectional study design.

MATERIALS AND METHODS: Pregnant women (n = 135) underwent ultrasonography. The coefficient of variation (CV) for hepatic volume scans obtained at 0 and 20 minutes and hepatic area tracings, performed twice for each scan, was determined (n = 20; range, 23–36 weeks). Normal data for hepatic volume and head and upper abdominal circumferences were obtained (n = 85; range, 20–36 weeks) and related to data from growth-restricted fetuses (birth weight < P5 centile; n = 24; range, 22–36 weeks).

RESULTS: CV was 2.9% for volume scans and 1.6% for area tracings. In 85 uncomplicated cases, mean fetal hepatic volume (P50 centile) was 9.7 mL ± 4.4 (SD) at 20 weeks and 96.4 mL ± 8.2 at 36 weeks of gestation. In 24 growth-restricted fetuses, hepatic volume, head circumference, and upper abdominal circumference expressed as percentages of the normal P50 centile were 45%, 90%, and 82%, respectively. Mean difference in hepatic volume between fetal growth restriction and normal fetal development, as expressed with the z score, -4.32 ± 1.4, was significantly different (P < .05) from that for head circumference, -3.04 ± 1.3, but not from that for upper abdominal circumference, -4.7 ± 1.2. Fetal hepatic measurement was obtained in 109 pregnancies.

CONCLUSION: Acceptable reproducibility exists for hepatic volume determinations. In fetal growth restriction, reduction is more pronounced for hepatic volume than for head or upper abdominal circumference; hepatic volume is a better discriminator than head circumference but not upper abdominal circumference.

© RSNA, 2002

Index terms: Abdomen, US, 856.128, 856.12981 • Fetus, central nervous system, 856.871 • Fetus, gastrointestinal tract, 856.871 • Fetus, growth and development, 856.871 • Fetus, US, 856.128, 856.12981

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