Re: Fetal Liver.....Echogenic Portal Triad

From: Peg Beutler, RDMS (kpnb@voyager.net)
Thu Jul 5 15:01:34 2001

Oops...forgot to sign...haven't posted in a while...sorry about that. I don't know much about this patient other than she thought she was about 18 weeks, and has only just now started prenatal care. When I noticed the liver, I did ask her if she'd been sick during this pregnancy, had any viral infections, or been exposed to any viruses, and she denied all. The liver and spleen were both normal in size. Spleen was easy to see, and was homogeneous. There were no calcifications. The HC/AC ratios were normal. All parameters of both fetuses measured within a week of 31 weeks, and the EFW's were only about 30g difference. If I can get a good pic from the tape, I will, but the images I printed for the perinatologist weren't much help. You couldn't get a good idea of the extent of the finding from a still image. Any more ideas? 

--
Peg Beutler, RDMS


At Thu, 5 Jul 2001, DuBose, Terry wrote:
>
>There are a number of fetal infections that cause visceromegaly, enlargement
>of the liver and spleen.  These are often called the TORCH infections
>(TOxoplasmosis, Rubella, Cytomegalovirus, & Herpes).  Some have suggested
>the acronym STARCHS to include Syphilis and the opportunistic infections
>associated with AIDS.
>
>These fetuses may also exhibit varying degrees of bowel calcifications,
>microcephaly with brain calcifications.  But all fetuses do not show all of
>these signs.  How were the measurements... Head/Abdomen Circumference
>Ratios?
>
>Too bad there are no images... that might help.  Good luck.
>
>PS, because this Forum is for professionals, it is always nice and
>interesting to know to whom we are messaging and where in the world you are.
>
>Peace, Terry J. DuBose, M.S., RDMS, APS
>Chair, Ultrasound Section OBGYN.net
>Assistant Professor & Director, Diagnostic Medical Sonography Program
>CHRP, University of Arkansas for Medical Sciences
>Little Rock, Arkansas, USA
>501-686-6510
>http://www.io.com/~dubose/
>http://www.uams.edu/CHRP/dmshome.htm
>http://www.obgyn.net/us/panel/panel.htm
>
>-----Original Message-----
>From: kpnb@voyager.net [mailto:kpnb@voyager.net]
>Sent: Thursday, July 05, 2001 1:16 PM
>To: Multiple recipients of list ULTRASOUND
>Subject: Fetal Liver.....Echogenic Portal Triad
>
>This is a twin pregnancy, scanned for the first time at 31w2d.
>The liver of Fetus A was hypoechoic, with echogenic portal triads
>throughout the entire liver.  Liver size and location was appropriate.
>This was the only unusual finding for that fetus.
>Fetus B appeared completely normal.
>I wasn't able to determine chorionicity, but there is a membrane between
>them.  Both fetuses are female.
>I don't have an image for you.  But it looked just like the liver of an
>adult with hepatitis.
>Any ideas?



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