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Radiology
Hepatic Anomalies
Built from Obstetric Imaging
What’s inside
9 sections · 109 slides
Overview
- What this topic covers
- Why the fetal liver repays a careful look
- Three patterns to sort a liver finding into
- How these diagnoses are made
Liver tumours
Rare, mostly benign, and told apart by texture and Doppler flow
- Fetal liver tumours: the headline facts
- ~5%
- How to read the liver-lesion table
- Sonographic Findings in Fetal Liver Lesions
- Haemangioma: what it is
- Haemangioma: how it behaves over time
- Haemangioma: what can go wrong
- Haemangioma: what can be done
- Liver haemangioma on grayscale and power Doppler
- What to notice in those two panels
- Mesenchymal hamartoma: what it is
- Mesenchymal hamartoma: course and company
- Mesenchymal hamartoma on ultrasound
- Two look-alike masses, split by Doppler
- Hepatoblastoma: what it is
- Why hepatoblastoma prefers the right lobe
- Hepatoblastoma: risks and associations
- Hepatoblastoma on ultrasound
- Hepatoblastoma in multiplanar and colour Doppler views
Calcifications and cysts
Bright specks and black spaces - common, usually benign, occasionally a warning
- Hepatic calcifications: what they are
- Where liver calcifications come from
- What to do when liver calcifications are seen
- What liver calcifications mean
- Bright calcium specks in the fetal liver
- Hepatic cysts: what they are
- One cyst or many?
- Cysts: how common, and why they form
- What happens to a fetal liver cyst
- Treating a liver cyst
- Liver cysts on ultrasound
- Single and multiple cysts in the fetal liver
- Cysts can appear very early
- Liver cyst seen in the first trimester
Congenital intrahepatic shunts
Blood vessels joined where they should not be
- What an intrahepatic shunt is
- Three ways liver vessels short-circuit
- What each shunt does to the fetus
- Portosystemic shunts, and how shunts are treated
- Hereditary haemorrhagic telangiectasia
- Shunts on ultrasound
The enlarged fetal liver
How to call it, and the shortlist of causes it opens
- What hepatomegaly means
- Liver reaching down into the fetal pelvis
- Measuring the fetal liver, step by step
- Normal fetal liver length on a long-axis view
- Reading the liver-length chart
- Normal fetal liver length against gestational age
- Three ways to size the fetal liver
- What makes a fetal liver big
- The four buckets of cause
- Turning a big liver into a shortlist
- Features of Fetal Hepatomegaly — additional findings
- Features of Fetal Hepatomegaly — key points, additional investigations
Infection
The commonest infectious causes of an enlarged fetal liver
- TORCH: the memory word
- Cytomegalovirus
- Parvovirus
- Congenital syphilis
- Why infection enlarges the liver
Metabolic and genetic causes
Diabetes, overgrowth syndromes and the storage diseases
- Diabetes in pregnancy
- How much bigger is the liver in diabetes
- Which measurement to follow in diabetes
- Beckwith-Wiedemann syndrome: what it is
- The Beckwith-Wiedemann triad
- Enlarged tongue between the lips on a profile view
- Beckwith-Wiedemann: major findings
- Beckwith-Wiedemann in pregnancy and after birth
- Beckwith-Wiedemann: tumour risk
- Beckwith-Wiedemann on ultrasound
- Storage diseases: the general idea
- Zellweger syndrome
- Zellweger syndrome on imaging
- Niemann-Pick disease
- How the Niemann-Pick types differ
- Niemann-Pick disease on ultrasound
- Gaucher disease
- Gaucher disease: testing and scan findings
- Gestational alloimmune liver disease
- What the three-plane view adds
- Enlarged liver in fetal metabolic disease, three planes
Blood disorders
Anaemia, abnormal blood-cell production and fetal leukaemia
- Anaemia enlarges the liver
- How anaemia ends in a big liver and hydrops
- The numbers behind the blood causes
- Abnormal blood-cell production in trisomy 21
- Fetal and congenital leukaemia
- Severe fetal anaemia on ultrasound
- Liver length in trisomy 21 with a myeloproliferative disorder
Bringing it together
Where MRI helps, the classic signs, and a working approach
- Where MRI helps
- Classic signs to carry away
- “
- Key points
- A working approach at the scan
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- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition