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368: Implications for prenatally diagnosed liver calcifications and abdominal echogenic foci

      Objective

      The purpose of this study is to examine cases of prenatal calcifications in the liver and abdominal echogenic foci, and determine the clinical significance of these findings.

      Study Design

      A retrospective, non-blinded chart review was performed from 2004 through 2009. 38 cases were identified from our ultrasound database. Exclusion criteria were incomplete records or patients lost to follow-up.

      Results

      The incidence of these ultrasound findings was 1 in 430 cases. Seven cases had the isolated ultrasound findings of liver calcifications or abdominal echogenic foci. These children had a postnatal abdominal x-ray or ultrasound performed, and two of the seven cases had liver calcifications. These findings were diagnosed as a calcified hemangioma or vascular calcification in one case and a nonobstructive thrombus in the L. portal vein in the other case. Both of these children had otherwise normal exams at birth. Twenty-one cases had other ultrasound anomalies in conjunction with liver calcifications and abdominal echogenic foci. There was a range of concurrent anomalies: hydrops (10%), renal pyelectasis (14%), club feet (10%), intracardiac echogenic foci (28%) and IUGR (10%). Single cases of Dandy-walker, severe ventriculomegaly and an abdominal mass were seen. These children tended to have poorer prognoses; their outcomes entailed chromosomal abnormalities (19%), extreme premature births (19%), and meconium perforation (10%).

      Conclusion

      The prenatal findings of liver calcifications or an echogenic focus in the abdomen seem to be a benign finding as an isolated abnormality. An imaging study is recommended for the infant in the postnatal period. This evaluation may reveal a vascular abnormality but generally these children seem to have good short term prognoses. However, if these ultrasound findings are seen concurrently with other anomalies, these children seem to have a poorer prognosis.