Isolated echogenic foci in the left upper quadrant of the fetal abdomen: are they significant?
OBJECTIVE
To evaluate fetuses with echogenic foci in the left upper quadrant of the abdomen by sonographic examination.


METHODS
Between November 2000 and October 2001, we prospectively assessed fetuses with echogenic foci in the abdominal left upper quadrant on routine prenatal sonography. The location, number, and size of the foci were analyzed, and in utero and postpartum follow-up scans were performed. A pediatrician evaluated the perinatal outcome.


RESULTS
Twenty-six fetuses had 35 echogenic foci in the left upper quadrant of the abdomen at gestational ages of 20 to 37 weeks. The locations of the foci along the stomach, spleen, and the left lobe of the liver were found on sonography and measured 2 to 5 mm. Of the 16 fetuses who had follow-up scans in utero, 7 had disappearance of the foci. Postpartum follow-up scans were performed in 12 cases. Among them, 9 neonates had no lesions, and 3 had echogenic foci of a size and appearance similar to those seen prenatally in the left lobe of the liver. Only 1 of 4 patients who had TORCH (toxoplasmosis, other, rubella, cytomegalovirus, and herpes simplex) titers evaluated had elevated immunoglobulin G levels; no patient had any sign of infection after birth. All fetuses had a normal postnatal outcome.


CONCLUSIONS
Many echogenic foci in the left upper quadrant of the fetal abdomen will disappear, and the outcome is promising even when the lesion persists after birth.
Ji
Eun-Kyung
EK
Department of Diagnostic Radiology, Cha General Hospital, College of Medicine, Pochon Cha University, Seoul, South Korea. jiekkorea@hanmail.net
Lee
Eun Kyung
EK
Kwon
Tae Hee
TH
D000005:Abdomen / Q000002:abnormalities / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000002:abnormalities / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013154:Spleen / Q000002:abnormalities / Q000000981:diagnostic imaging; D013270:Stomach / Q000002:abnormalities / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal