Fetal small bowel simulating an abdominal mass at sonography

Manco, Lawrence G.; Nunan, Francis A.; Sohnen, Howard; Jacobs, Edward J.

doi:10.1002/jcu.1870140516

Cited by 16 publications

(9 citation statements)

References 8 publications

(3 reference statements)

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“…Fetal meconium production does not begin until the second tri mester and may be a cause for the appearance of hyperechoic fetal bowel at this stage in fetal development [6]. In normal fetuses, the hyper echoic image of the fetal bowel usually disap pers by 20 weeks on serial sonograms [1][2][3]. In the present series, echogenic fetal bowel ap pears to be consistent with a normal neonatal outcome in the majority of cases.…”

Section: Discussionmentioning

confidence: 46%

“…CMV). However, hyperechoic fetal bowel may also be a normal finding in the second trimester [1][2][3]. Fetal meconium production does not begin until the second tri mester and may be a cause for the appearance of hyperechoic fetal bowel at this stage in fetal development [6].…”

Section: Discussionmentioning

confidence: 99%

“…Fetal echogenic bowel can be a normal ultrasound finding in the second trimester [ 1 -3], In normal fetuses, the hyperechoic appear ance of the fetal bowel usually disappears by 20 weeks on serial sonograms [1][2][3]. However, echogenic fetal bowel has also been associated with meconium ileus and/or meconium peri tonitis [1,[4][5][6][7], This association is especially strong in fetuses screened due to a 1:4 risk of cystic fibrosis [1,4], Benacerraf and Chaudhury [8] postulated that echogenic fetal small bowel which persists into the third trimester is more likely to reflect the presence of meconi Supported in part by NIH grant HD24494…”

Section: Introductionmentioning

confidence: 99%

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Fetal Echogenic Bowel on Ultrasound: Is There Clinical Significance?

et al. 1994

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Though echogenic fetal bowel has been associated with meconium ileus and/or peritonitis, it may be a normal finding in the second trimester. The purpose of this study is to determine which characteristics might distinguish fetuses ultimately having abnormal outcomes in a population at low risk for cystic fibrosis. Seven fetuses with echogenic bowel were identified: 5 fetuses ≤ 20 weeks gestation (group 1) and 2 fetuses 20–25 weeks gestation (group 2) at diagnosis. Four of 5 group 1 fetuses had resolution of the echogenic bowel during the second trimester. One group 2 fetus had a persistent mass associated with growth deficiency and trisomy 18. The neonatal bowel evaluation was normal in the remaining 2 fetuses although echogenic findings persisted into the third trimester. In a low-risk population, echogenic bowel usually resolves without neonatal sequelae. Even when persistent into the third trimester, echogenic bowel does not uniformly herald an abnormal outcome. Echogenic bowel coexistent with other abnormalities (such as growth deficiency or structural malformations) may be a comarker for aneuploidy.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fetal Echogenic Bowel on Ultrasound: Is There Clinical Significance?

et al. 1994

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“…Nonetheless, ultrasonographic detection of an abdominal mass may correspond to other fetal pathologies, such as teratoma, neuroblas toma or duplicated intestine filled with intes tinal fluid or blood from intracavitary hemor rhage or normal variant [ 19], Echogenicity is only seen in 1 of 175 'nor mal' controls. Therefore, one might consider using this as a screening test for cystic fibrosis in the overall population since the majority of fetuses having cystic fibrosis will display this sign.…”

Section: Bowel Echogenicitymentioning

confidence: 99%

Prenatal Diagnosis of Cystic Fibrosis: Ultrasonography of the Gallbladder at 17–19 Weeks of Gestation

et al. 1993

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We have investigated the ultrasonographic signs that can help in the prenatal diagnosis of cystic fibrosis in 197 risk fetuses and compared them with 353 control fetuses. In 60 fetuses with a 1:4 risk for the disease, the gallbladder was also examined. All ultrasonograms were performed just before amniocentesis at 17–19 weeks of gestation. A previously described intra-abdominal hyperechogenic mass was found in 73% of the 48 affected fetuses, but 32 of the 149 unaffected fetuses also had this feature, giving a specificity of 77% and a sensitivity of 78%. When we investigated the gallbladder, we found 9 of the 12 affected fetuses to be without evidence of a gallbladder during the sonographic examination (none of the healthy or control fetuses had such a feature), giving a positive predictive value of 100%, a specificity of 100% and a sensivity of 75%. The combined presence of an abnormal gallbladder and a hyperechogenic intra-abdominal mass yields the same positive predictive value and specificity, but does not improve the accuracy. Ultrasonography appears to be a good additional diagnostic tool for the prenatal diagnosis of cystic fibrosis, especially when the enzyme activities disagree. Furthermore, these results lead us to think that such a finding during routine ultrasonographic examination at 17–29 weeks could be a means of screening for cystic fibrosis. The absence of the gallbladder during the sonographic examination of fetuses at risk for cystic fibrosis at 17–19 weeks of gestation can help in the prenatal detection of the disease.

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“…Increased echogen icity in the fetal abdomen, as revealed by ultrasonogra phy, has been associated with several pathologic condi tions such as meconium peritonitis [1][2][3][4][5][6], meconium ileus [7,8], neoplasms and infections. However, several au thors [9][10][11] reported on increased intestinal echogenicity with subsequent normal neonatal outcome. These con flicting observations raise the importance of an objective definition o f 'increased echogenicity' and the accuracy of the sonographer's ability to differentiate slight variations in reflectivity.…”

Section: Introductionmentioning

confidence: 99%

The Accuracy of the Assessment of Normal Fetal Intestinal Echogenicity – Electro-Optical Densitometry versus the Ultrasonographer’s Eye

Caspi¹,

Blickstein²,

Appelman

1992

Gynecol Obstet Invest

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Ten plates of normal fetal ultrasonography (at 16-20 weeks’ gestation) showing fluid, liver, lung, bone and intestine were submitted to electro-optical transmission surface densitometry. A distinct echogenic gradient has been found and used as an ‘internal standard’ to evaluate intestinal echogenicity. Intestine had significantly different echogenic properties from bone, liver and fluid but similar to that of lung. Using this echogenicity scale for fetal bowel, observers were correct in 46%, overscored in 32.6% and underscored in 21.4%. These poor results may be due to the significant inconsistency in the interpretation of each plate compared to other plates (about 65%). Although the densitometry-derived grading scale seems valid at these gestational ages, interobserver variation is too large and precludes a simple ultrasonic diagnosis of the hyperechogenic fetal intestine. Densitometric evaluation may be indicated in suspected cases when fetal bowel seems to have increased echogenicity.

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Fetal small bowel simulating an abdominal mass at sonography

Cited by 16 publications

References 8 publications

Fetal Echogenic Bowel on Ultrasound: Is There Clinical Significance?

Fetal Echogenic Bowel on Ultrasound: Is There Clinical Significance?

Prenatal Diagnosis of Cystic Fibrosis: Ultrasonography of the Gallbladder at 17–19 Weeks of Gestation

The Accuracy of the Assessment of Normal Fetal Intestinal Echogenicity – Electro-Optical Densitometry versus the Ultrasonographer’s Eye

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