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Intraabdominal Fetal Echogenic Masses: A Practical Guide to Diagnosis and Management¹

¹ From the Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA 02215. Recipient of a Certificate of Merit award and an Excellence in Design award for an education exhibit at the 2002 RSNA Scientific Assembly. Received June 3, 2004; revision requested August 5 and received September 2; accepted September 8. All authors have no financial relationships to disclose. Address correspondence to D.L. (e-mail: dlevine{at}bidmc.harvard.edu).

Intraabdominal calcifications and other echogenic masses are relatively common findings during fetal sonography. Many are associated with no additional risk for the fetus or neonate. They may arise from the liver, gallbladder, spleen, kidneys, adrenal glands, gastrointestinal tract, or peritoneal cavity. Detection of such lesions should prompt a detailed survey for additional findings and a review of the maternal history. In some cases, fetal karyotyping may be indicated. In most cases, the diagnosis, management, and outcome are determined according to a combination of specific ultrasound appearances and at least one additional maternal or fetal factor. In utero diagnosis can often be achieved with careful evaluation of the lesion echotexture, associated calcifications, additional findings, and evolution over time. In most cases, expectant management is sufficient, but some patients require transfer to a facility where early postnatal intervention is available. A systematic approach to the findings aids in differential diagnosis and management.

© RSNA, 2005