Avni E F, Rypens F, Donner C, Cuvelliez P, Rodesch F
Department of Radiology, Erasme Hospital, University Clinics of Brussels, Belgium.
Pediatr Radiol. 1994;24(8):569-72. doi: 10.1007/BF02012734.
The authors report their experience with the perinatal diagnosis of six cases of hepatic cyst and six of liver hyperchogenicities. The in utero diagnosis of hepatic cysts was difficult when the cysts were large or subhepatic. A precise diagnosis was sometimes achieved only after surgery. Small intraparenchymal cysts tended to regress spontaneously. Liver hyperechogenicities were diffuse or localized. They were unrelated to liver infection, tumors, meconium peritonitis or biliary tract anomaly. Both entities could be related to vascular disruption phenomenon (VDP) in which structural anomalies result from damage to normal development of embryonic or fetal vessels with anomalies of perfusion to the developing organs. The consequences of VDP to the liver are variable depending on the time and duration of the phenomenon. Localized infarct or ischemia can fibrose or calcify leading to segmental hyperechogenicities. Necrosis with tissue reabsorption can be the origin of some (sub)hepatic cysts. When such anomalies are detected there should be a careful study of the placentation, and a search for potential associated anomalies should be undertaken.
作者报告了他们对6例肝囊肿和6例肝脏高回声病变进行围产期诊断的经验。当囊肿较大或位于肝下时，子宫内肝囊肿的诊断很困难。有时只有在手术后才能做出准确诊断。小的实质内囊肿往往会自发消退。肝脏高回声病变可为弥漫性或局限性。它们与肝脏感染、肿瘤、胎粪性腹膜炎或胆道异常无关。这两种情况都可能与血管破坏现象（VDP）有关，在这种现象中，结构异常是由于胚胎或胎儿血管正常发育受损以及发育中器官灌注异常所致。VDP对肝脏的影响因该现象发生的时间和持续时间而异。局部梗死或缺血可发生纤维化或钙化，导致节段性高回声。组织重吸收引起的坏死可能是一些（肝下）囊肿的起源。当检测到此类异常时，应仔细研究胎盘情况，并寻找潜在的相关异常。
