Quantitative anatomy of the liver visceral surface in the human fetus

Understanding liver growth is relevant in both determining the status of normative fetal development and prenatal detection of its disorders. This study attempted to examine age-specific reference intervals and the best-fit growth dynamics of the liver visceral surface for hepatic height, length, isthmic diameter, oblique diameters, circumferences of individual lobes, and total liver circumference. Using anatomical, digital and statistical methods, the liver visceral surface was measured in 69 human fetuses of both sexes (32 males and 37 females) aged 18-30 weeks, derived from spontaneous abortions and stillbirths. The statistical analysis showed no sex differences. The best growth models mostly followed natural logarithmic functions, except for the length of the fissure for ligamentum teres hepatis and the length of fossa for gallbladder, which increased commensurately. Neither the length of fissure for ductus venosus nor the length of sulcus for inferior vena cava modeled the best-fit curves. The vertical-to-transverse diameter ratio of the liver was constant and averaged 0.75 ±0.12, while the isthmus ratio significantly altered from 0.78 ±0.07 at 18-19 weeks through 0.68 ±0.05 at 26-27 weeks to 0.72 ±0.07 at 28-30 weeks of gestation. With no sexual differences, the liver morphometric parameters increased either logarithmically (lengths of: transverse diameter, vertical diameter, right oblique diameter, left oblique diameter, isthmic diameter and porta hepatis, circumferences of: right lobe, left lobe, quadrate lobe, caudate lobe, and total liver circumference) or proportionately (length of fissure for ligamentum teres hepatis, length of fossa for gallbladder). The quantitative data of the growing liver may be relevant in both the ultrasound monitoring of fetuses and early detection of congenital liver anomalies.