Echogenicities in the fetal gallbladder: Prevalence, sonographic findings, and postnatal outcomes

Abstract

Purpose: To investigate the prevalence of echogenicity in the fetal gallbladder (EFG) and to present prenatal sonographic findings and their postnatal outcomes. Materials and Methods:We performed a retrospective study within 17420 pregnant women during a 66-month period. Fetuses with an incidental finding of EFG in their 2nd or 3rd trimester of pregnancy were followed until birth per two weeks with sonographic examinations.Results: Out of 5977 fetuses, 44 fetuses were found to have EFG with a prevalence of 0.74%. Nine (20%) of 44 fetuses had single echogenicity, 25 (56%) had multiple echogenicities, 10 (22%) had sludge-like echogenicities. In Doppler sonography, 28 fetuses with EFG exhibited twinkling artifacts; however, none of the echogenicities had obvious acoustic shadowing. All of the cases were resolved either in utero or after birth before 10 months of age. Conclusion:EFG is a late third-trimester phenomenon with a prevalence of 0.74%.Most EFGs presented as twinkling artifacts, suggesting they had a cholesterol component.

Improving prenatal detection of abdominal supraumbilical anomalies: The sonographic examination of fetal anechoic spaces of upper abdomen revisited

“…Gallstones can be single or multiple, occasionally display a “comet tail” artifact, 40 and, as they are mainly composed of precipitated cholesterol and bile pigments, do not produce acoustic shadowing (Figure 5B). Biliary sludge/gallstones are usually of no significance and can typically be considered a benign condition without associated neonatal complications 36–38 . In our cohort, 49 cases of biliary sludge/gallstones were detected at a median gestational age of 34 weeks (range, 31–39), for a prevalence of 0.7% or 1 in 147 scans performed between 25 and 40 weeks.…”

“…Biliary sludge/ gallstones are usually of no significance and can typically be considered a benign condition without associated neonatal complications. [36][37][38] In our cohort, 49 cases of biliary sludge/gallstones were detected at a median gestational age of 34 weeks (range, 31-39), for a prevalence of 0.7% or 1 in 147 scans performed between 25 and 40 weeks. No perinatal complications were noted in these cases.…”

“…The detection of echogenic material in the fetal GB, on the other hand, can be a frequent finding during the third trimester, at a time when the bile can change from anechoic to homogeneously echogenic (biliary sludge) or contain a variable number of echogenic masses (gallstones). [36][37][38] Biliary sludge/gallstones almost exclusively occur in the third trimester. [36][37][38] In our cohort, a frequent cause of a poorly or non-visualized GB was found in association with the presence of biliary sludge (Figure 5A).…”

“…[36][37][38] Biliary sludge/gallstones almost exclusively occur in the third trimester. [36][37][38] In our cohort, a frequent cause of a poorly or non-visualized GB was found in association with the presence of biliary sludge (Figure 5A). In particular, biliary sludge has a similar echogenicity than hepatic tissue, so a sludge- Although a similar scenario can be found in cases of a gallstonefilled GB, the echogenicity of the gallstones often makes the diagnosis easier.…”