Percentiles of intrauterine placental volume and placental volume relative to fetal volume: A prospective magnetic resonance imaging study.

INTRODUCTION: We aimed to provide percentiles of intrauterine placental growth and placental growth relative to fetal growth (placental to fetal ratio) by measuring placental and fetal volumes by magnetic resonance imaging (MRI). METHODS: In this prospective study, 107 unselected singleton pregnancies were examined by MRI at gestational week 27 and 37. Based on the estimated volumes of the placenta and the fetus, we calculated median and percentiles at gestational weeks 27 and 37. RESULTS: Median placental volume at gestational week 27 was 513 cm3 (Inter Quartile Range (IQR) 182 cm3), and 831 cm3 (IQR 252 cm3) at week 37. The 10th - 90th percentiles included placental volumes between 392 and 717 cm3 at gestational week 27, and 631-1087 cm3 at week 37. The placental to fetal ratio was significantly higher at gestational week 27 than at week 37, with a median ratio of 0.54 (IQR 0.18) and 0.31 (IQR 0.08), respectively (p < 0.001). The 10th-90th percentiles included placental to fetal ratios between 0.43 and 0.73 at gestational week 27 and 0.25-0.39 at week 37. DISCUSSION: At gestational week 27, the placental volume was about half the size of the fetal volume, whereas at week 37, the placental volume was about one third of the fetal volume. This finding suggests that placental growth was less prominent than fetal growth after gestational week 27. Knowledge about the distribution of intrauterine placental size in the general population of pregnancies are prerequisites for diagnosing abnormal placental size.

Bowel MR imaging with oral Gastrografin: an experimental study with healthy volunteers.

Our objective was to evaluate Gastrografin for MR bowel imaging. Twenty-three healthy volunteers in two randomised groups received 300 or 400 ml 50% Gastrografin, drunk continuously during 2 and 3 h, respectively. Images were applied during breath-hold in three orthogonal orientations. The balanced fast-field echo (BFFE) and balanced turbo field-echo (BTFE) sequences, with acquisition times from 13 to 25 s, were used before gadolinium (Gd) DTPA implying 1- to 2-mm-thick slices locally or 6-mm-thick slices through the entire gastrointestinal tract. The Gd-enhanced images were performed using a 3D T1-weighted FFE sequence with water selective excitation (Proset). Image quality, including bowel distention, homogeneity of opacification and wall conspicuity, were evaluated by two experienced reviewers, and the adverse reactions were recorded. Very good or excellent distention, homogeneity and wall conspicuity were achieved in the central segments from the ileum to the left colon flexure in 83-96% of cases, due to the adequate contrast media supply in these regions. Distention, homogeneity and delineation were good in the central segments of the remaining bowels. Diarrhoea was a major problem affecting all participants, followed by nausea. Provided that there is modern fast sequential technology, excellent MR imaging of the bowel can be achieved by the oral administration 50% diluted Gastrografin. Further studies are needed to refine the technique and optimise the quantity and concentration of Gastrografin in order to avoid or reduce adverse reactions.