OC18.09: Splenic vessels: runway lights to spot the fetal pancreas

Abstract

To assess the utility of splenic vessels in delineation of fetal pancreas and its implications in clinical practice. 200 normal singleton fetuses between 17–22 weeks of gestation with normal pancreas and splenic vessels were included. 4 fetuses with variant anatomy were also included. The fetal pancreas was imaged using a transabdominal approach in an oblique section caudal to the plane of abdominal circumference using both grey scale and power Doppler with PRF setting between 0.6-0.9 kHz. The pancreas and splenic vessels were imaged with the fetal spine position between 3 to 9 o'clock position. The normal pancreas was seen as an echogenic structure with the splenic vessels coursing along its posterior border in all controls (figure 1a-d). Splenic artery is seen in figure 1b and splenic vein in figure 1d. One case each of enlarged pancreas (figure 1e) in a fetus with suspected Beckwith Wiedemann syndrome confirmed postnatally, normal right sided pancreas (figure 1f) in situs inversus, truncated pancreas (figure 1g) in left atrial isomerism and normal left sided pancreas with absent splenic vessels (figure 1h) likely due to asplenia in right atrial isomerism were included. Fetal pancreas is challenging to spot on grey scale ultrasound. Power Doppler lights up the splenic vessels which course along the posterior border of the pancreas serving as a useful landmark to delineate the pancreas. The knowledge of normal pancreatic and splenic vessel anatomy can help in detecting anomalies which are a part of several syndromes and situs abnormalities. This serves as a useful tool in our armamentarium to elucidate the fetal phenotype. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.