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EP15.17: Fetal brain to liver volume ratio measured by MRI is a useful indicator of IUGR in vivo in late gestation

2016; Wiley; Volume: 48; Issue: S1 Linguagem: Inglês

10.1002/uog.16997

1469-0705

Anqi Duan, Meng Yuan Zhu, Sharon Portnoy, Natasha Milligan, Jessie Mei Lim, Johannes Keunen, Christopher K. Macgowan, John G. Sled, John‏ Kingdom, Mike Seed,

Fetal and Pediatric Neurological Disorders

Fetal brain to liver weight ratio has been identified as a useful diagnostic tool of intrauterine growth restrictions (IUGR) in a study of stillborn babies and neonatal deaths [1]. We sought to investigate whether fetal brain to liver volume ratio (BLVR), measured by MRI, could be used as a potential indicator of IUGR in vivo in live fetuses. This study included 16 fetuses in the normal group and 15 fetuses in the IUGR group between 32 and 39 weeks gestation. Meeting ≥ 2 of the 4 criteria proposed by Zhu et al. were used to define IUGR [2]. MRI measurements of the fetal liver and body volumes were performed using high-resolution 3D SSFP breath-hold acquisitions and post-processed using Mimics. The mean whole body, liver and brain volumes, and mean BLVR of the two groups were compared using Student's t test. T2 relaxation times of the umbilical vein (UV) and descending aorta (DAo) were also obtained according to our previously published techniques [2]. The mean gestational ages were not significantly different in the two groups (35.9 weeks for normal and 35.3 weeks for IUGR) and were thereby controlled for. The IUGR group had a significantly lower mean liver volume (79mL vs 137mL, P < 0.001), and a lower mean brain volume (242mL vs 289mL, P < 0.01) compared to the normal group. There was a positive correlation between liver to body volume ratio, and UV and DAo T2 (Pearson, P < 0.05 for both UV T2 and DAo T2), indicating the effect of blood oxygen saturation on liver development. BLVR was significantly higher in the IUGR group than the normal group (3.43 vs 2.15, P < 0.001) and could therefore serve as a potential tool for diagnosing the condition in utero. BLVR is a useful indicator of IUGR in late gestation. Further investigation into its sensitivity and specificity for diagnosing IUGR, either alone or together with other predictors, is warranted.