Journal of Ultrasound in Medicine, Vol 18, Issue 10 691-695, Copyright © 1999 by American Institute of Ultrasound in Medicine
Three-dimensional ultrasonographic technology to assess and compare echodensity of fetal bowel, bone, and liver in the second trimester of pregnancy
M. Khandelwal, J. Silva, L. Chan and E. A. Reece
Department of Obstetrics, Gynecology, and Reproductive Services, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Increased fetal bowel echogenicity in the second trimester is used as a
marker for prenatal diagnosis of Down syndrome. The diagnosis of
hyperechogenicity is subjective. We sought to quantify and correlate fetal
bowel echogenicity with liver and bone in 47 normal fetuses, using
three-dimensional ultrasonographic technique and objective measurement of
gray scale distribution. No significant change was found in the organs'
echogenicity between 15 and 24 weeks of gestation, the optimal time for
detection of fetal chromosomal anomalies. A wide variability in bowel
density was noted within the normal group, which could explain its poor
sensitivity for the detection of Down syndrome. Bowel echodensity
correlates better with liver density than with bone density. Thus,
comparison of bowel to liver echogenicity, even with two-dimensional
sonography, may prove to be a more effective clinical tool in the
evaluation of fetal intra-abdominal echodensities.
