title: Congenital portosystemic shunts: prenatal manifestations with postnatal confirmation and follow-up.
abstract: OBJECTIVE
  The purpose of this study was to evaluate prenatal sonographic findings that could be helpful for diagnosis of congenital intrahepatic portosystemic venous shunts and the follow-up results.
  
  
  METHODS
  Six neonates with congenital shunts between the portal vein and hepatic vein were enrolled in this study. Prenatal sonography was performed in 5 cases. We categorized the cases according to a previously published classification of intrahepatic portosystemic venous shunts and retrospectively reviewed the prenatal and postnatal sonographic examinations to identify findings that might be helpful for diagnosing shunts prenatally. Follow-up sonographic examinations were done until closure of the shunts. Clinical features were also determined.
  
  
  RESULTS
  According to the original reports, intrahepatic portosystemic venous shunts were diagnosed by prenatal sonography in 2 of 5 cases. In the remaining 3 cases, there were suggestive abnormal findings on retrospective review, including an abnormal intrahepatic tubular structure, a prominent hepatic vein, and congestive heart failure. Postnatal sonography showed type 2 shunts in all 6 cases. In 1 case, there were 2 type 2 lesions between two branches of the left portal vein and the middle and left hepatic veins. On follow-up sonography, 5 of the 6 congenital shunts had spontaneously closed by 11 months of age. One case was treated with coil embolization during the neonatal period. Intrauterine growth restriction was the most commonly clinical feature prenatally.
  
  
  CONCLUSIONS
  Findings such as an abnormal tubular structure, a prominent hepatic vein, and congestive heart failure can be important clues for identifying congenital intrahepatic portosystemic venous shunts on prenatal sonography. The use of prenatal and postnatal sonography is feasible for detection and evaluation of these shunts.
authors.affiliation: Department of Radiology, Cheil General Hospital and Women’s Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.
authors.forename: Byoung Hee
authors.initials: BH
authors.lastname: Han
authors.forename: Sung Bin
authors.initials: SB
authors.lastname: Park
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Song
authors.forename: Kyung Sang
authors.initials: KS
authors.lastname: Lee
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Ko
authors.forename: Yeon Kyung
authors.initials: YK
authors.lastname: Lee
mesh_terms: D000328:Adult; D005260:Female; D006503:Hepatic Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D011169:Portal Vein / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*; D016157:Vascular Fistula / Q000151:congenital* / Q000000981:diagnostic imaging*