FETAL LIVER AND DIAPHRAGM

FETAL LIVER

• Large homogeneous organ which occupies most of the upper abdomen
• Homogeneously hyperechoic of similar or slightly less echogenicity than the fetal lung.
• Hepatic vessels, their branches and intrahepatic umbilical vein can be seen in all normal fetuses.

1- Umbilical vein (intrahepatic segment) 2- Liver 3- IVC 4- Descending aorta 5- Spleen 6- Fetal stomach

• Left Lobe.
• Larger than right lobe.
• Divided into two segments which can be imaged in the 2nd + 3rd trimester:
  Lateral segment - left of umbilical segment of left portal vein.
  Medial segment - lies between gallbladder (or middle hepatic vein superiorly) and umbilical segment of left portal vein or the intersegmental fissure more caudally
• Right Lobe.
• All hepatic tissue lying to the right of the gallbladder, middle hepatic vein and IVC (all reside in main lobar fissure).
• Normal liver length (Table) – Vintzileos et.al. 1985
• Normal liver length (Graph)– Vintzileos et.al. 1985

FETAL DIAPHRAGM

• Curvilinear hypoechoic structure best seen when the transducer is perpendicular to the muscle.
• Convex towards the lungs separating the chest and abdominal cavities.
• 2 - 3mm thick.
• Diaphragmatic motion can be demonstrated on real time images (important parameter in the biophysical profile).