Placental insufficiency with fetal intrauterine growth restriction (IUGR) is an important cause of perinatal mortality and morbidity and is subsequently associated with significant neurodevelopmental impairment in cognitive function, attention capacity, and school performance. The underlying biologic cause for this association is unclear. Twenty-eight preterm infants (gestational age 32.5 Ϯ 1.9 wk) were studied by early and term magnetic resonance imaging (MRI). An advanced quantitative volumetric three-dimensional MRI technique was used to measure brain tissue volumes in 14 premature infants with placental insufficiency, defined by abnormal antenatal Doppler measurements and mean birth weights Ͻ10 th percentile (1246 Ϯ 299 g) (IUGR) and in 14 preterm infants matched for gestational age with normal mean birth weights 1843 Ϯ 246 g (control). Functional outcome was measured at term in all infants by a specialized assessment scale of preterm infant behavior. Premature infants with IUGR had a significant reduction in intracranial volume (mean Ϯ SD: 253.7 Ϯ 29.9 versus 300.5 Ϯ 43.5 mL, p Ͻ 0.01) and in cerebral cortical gray matter (mean Ϯ SD: 77.2 Ϯ 16.3 versus 106.8 Ϯ 24.6 mL, p Ͻ 0.01) when measured within the first 2 wk of life compared with control premature infants. These findings persisted at term with intracranial volume (mean Ϯ SD: 429.3 Ϯ 47.9 versus 475.9 Ϯ 53.4 mL, p Ͻ 0.05) and cerebral cortical gray matter (mean Ϯ SD: 149.3 Ϯ 29.2 versus 189 Ϯ 34.2 mL, p Ͻ 0.01). Behavioral assessment at term showed a significantly less mature score in the subsystem of attention-interaction availability in IUGR infants (p Ͻ 0.01). Cerebral cortical gray matter volume at term correlated with attention-interaction capacity measured at term (r ϭ 0.45, p Ͻ 0.05). These results suggest that placental insufficiency with IUGR have specific structural and functional consequences on cerebral cortical brain development. These findings may provide insight into the structural-functional correlate for the developmental deficits associated with IUGR. An increasing number of developmental disorders (1, 2) and diseases (3, 4) in child and adult life are thought to have their origin in the fetal period. Central to this predisposition is fetal growth (5). The fetus receives its nutrients from the maternal/ uterine circulation via the placenta. Any disturbance in the placental-fetal circulation will therefore have severe consequences on the supply of important nutrients such as oxygen, glucose, and amino acids (6). The placenta itself is also an active endocrine organ and, therefore, changes in nutrient availability will also affect placental and, potentially, fetal endocrine function, in particular, the modification of the hypothalamo-pituitary-adrenal axis (7,8). Placental insufficiency, which is the most common cause of IUGR, has further been shown to be associated with a considerable perinatal mortality

Background Acoustic radiation force impulse (ARFI) imaging) is correlated with histopathological findings using METAVIR and semiquantitative scoring system (SSS) criteria for liver fibrosis.

ARFI is feasible in children at any age with an acceptable reliability. The depth of measurements in the liver seems to have no influence on test results. We set the standard ARFI elastography values for healthy liver in children.

4.