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| Prenatal ultrasound diagnosis and follow-up of fetal hepatic vascular malformation |
| WANG Yun-qin, ZHAO Yan, LI Chuan-hong |
| Yantaishan Hospital of Yantai, Yantai Shandong 264000, China |
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Abstract Objective: To investigate the prenatal ultrasonographic features of fetal hepatic vascular malformation and discuss its clinical value combining with outcome follow-up. Methods: We retrospectively analyzed sonographic features of 7 cases of fetal liver vascular malformation diagnosed by prenatal ultrasound in our hospital, and performed follow-up for the prognosis of intrahepatic arteriovenous fistula and portoveinous fistula. Results: Seven fetuses with gestational age of 29~39 weeks were diagnosed including 4 cases of intrahepatic arteriovenous fistula, 2 cases of portovenous fistula, 1 case of intrahepatic arteriovenous fistula with portovenous fistula. According to 2-year follow-up after birth, 4 cases of intrahepatic arteriovenous fistula had no clinical symptoms after birth. Among them, 2 cases were cured after interventional operation, the lesion of 1 case disappeared after six months, and the size of the lesion decreased in 1 case six months after birth. In 2 cases of hepatic portovenous fistula, 1 infant died after birth, the other one which was combined with esophageal atresia and intracranial arachnoid cyst underwent induced labor. One case of intrahepatic arteriovenous fistula combined with portovenous fistula underwent induced labor. The ultrasound images of fetal hepatic vascular malformation showed cystic, tubular or irregular anechoic drainage between hepatic artery or portal vein and hepatic vein, filled with blood flow signal in CDFI. Thickened hepatic proper arteries were found in intrahepatic arteriovenous fistula, spectral Doppler showed lesions of high speed low resistance artery-like spectrum. The portoveinous fistula was connected with the hepatic vein, and the spectrum changed into a single-phase continuous blood flow. There were two peaks and two troughs, which were similar to the spectrum of the venous catheter. Conclusion: Prenatal fetal hepatic vascular malformation has characteristic ultrasound findings, and ultrasonography could be used as the first choice of examination modality. It is of great importance in guiding clinical treatment.
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Received: 27 November 2017
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