title: Hepatic involvement in HELLP syndrome: an update with emphasis on imaging features.
abstract: HELLP syndrome, which consists of hemolysis, elevated liver enzymes, and low platelet count is an unusual complication of pregnancy that is observed in only 10% to 15% of women with preeclampsia. Hepatic involvement in HELLP syndrome may present with various imaging features depending on the specific condition that includes nonspecific abnormalities such as perihepatic free fluid, hepatic steatosis, liver enlargement, and periportal halo that may precede more severe conditions such as hepatic hematoma and hepatic rupture with hemoperitoneum. Maternal clinical symptoms may be nonspecific and easily mistaken for a variety of other conditions that should be recognized. Because hepatic hematoma occurring in association with preeclampsia and HELLP syndrome is a potentially life-threatening complication, prompt depiction is critical and may help reduce morbidity and mortality. This review provides an update on demographics, risk factors, pathophysiology, and clinical features of hepatic complications due to HELLP syndrome along with a special emphasis on the imaging features of these uncommon conditions.
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France. laetitia.perronne@gmail.com.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Perronne
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France. anthony.dohan@lrb.aphp.fr.|Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010, Paris, France. anthony.dohan@lrb.aphp.fr.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dohan
authors.affiliation: Department of Radiology, CHU d'Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France. paul.bazeries@gmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Bazeries
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France. docyoucef05@yahoo.fr.
authors.forename: Youcef
authors.initials: Y
authors.lastname: Guerrache
authors.affiliation: Department of Imaging, CHU de Caen, Avenue de la Côte-de-Nacre, 14033, Caen Cedex 9, France. fohlen-a@chu-caen.fr.
authors.forename: Audrey
authors.initials: A
authors.lastname: Fohlen
authors.affiliation: Department of Radiology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Claude Bernard University Lyon 1, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France. roussetpascal@gmail.com.
authors.forename: Pascal
authors.initials: P
authors.lastname: Rousset
authors.affiliation: Department of Radiology, CHU d'Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France. ChAube@chu-angers.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Aubé
authors.affiliation: Department of Radiology, CHU Nancy-Brabois, Université de Lorraine, Allée du Morvan, 54511, Nancy Cedex, France. v_croiselaurent@yahoo.fr.
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurent
authors.affiliation: Obstetrics and Fetal-Medicine Unit, CHU de Nancy, Université de Lorraine, 10, Rue Heydenreich, 54000, Nancy, France. olivier.morel17@gmail.com.
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France. mourad.boudiaf@lrb.aphp.fr.
authors.forename: Mourad
authors.initials: M
authors.lastname: Boudiaf
authors.affiliation: Department of Radiology, Hôpital Robert Debré, 11 Boulevard Pasteur, 51092, Reims, France. choeffel-fornes@chu-reims.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière-APHP, 2, Rue Ambroise Paré, 75010, Paris, France. philippe.soyer@lrb.aphp.fr.|Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010, Paris, France. philippe.soyer@lrb.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
mesh_terms: D005260:Female; D017359:HELLP Syndrome / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008099:Liver; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011247:Pregnancy; D012307:Risk Factors
keywords: HELLP syndrome; Hepatic hematoma; Hepatic infarct; Hepatic rupture; Imaging; MDCT; Preeclampsia; Pregnancy complications; Transcatheter arterial embolization; Ultrasonography