Prenatal ultrasound diagnosis and clinical outcomes of fetal hepatohilar cystic occupying lesions

Abstract

Objective To explore the prenatal ultrasound diagnosis and postnatal clinical outcomes of fetuses with hepatohilar cystic occupying lesions. Methods This was a retrospective study that included all fetuses found to have hepatohilar cystic occupying lesions diagnosed by ultrasound in the First Affiliated Hospital of Sun Yat-sen University between January 2008 and December 2017. According to the morphology of the cyst and max diameter, the cases were divided into four groups. Cases with polygonal cysts and max diameter over 30 mm were assigned to group 1, non-polygonal cysts and max diameter over 30 mm to group 2, polygonal cysts and max diameter under 30 mm to group 3, non-polygonal cysts and max diameter under 30 mm to group 4. The birth status, ultrasound review image, surgical treatment and pathological findings were tracked to analyze the prognosis of these fetuses. Results Among 47 cases of fetal hepatohilar cystic occupying lesions, 38 fetuses were born and 9 were terminated with only 1 case taking pathological examination. There were 39 cases with pregnancy outcomes. Twenty-seven cases (69.2%, 27/39) were diagnosed as congenital biliary dilatation (CBD), 5 cases (12.8%, 5/39) were found cysts resolved in postnatal ultrasound examinations. Biliary atresia was diagnosed in 3 cases (7.8%, 3/39) by operation; Mesenteric cysts (5.1%, 2/39) were diagnosed in 2 cases by ultrasound. One (2.6%, 1/39) was diagnosed as double-gallbladder by ultrasound. 1(2.6%, 1/39) was diagnosed as teratoma by operation. Most cases were in the group 3, but there was no significant difference compared with other groups (all P>0.05). Conclusions More than half of hepatohilar cystic occupying lesions diagnosed in prenatal ultrasound are proved to be CBD with good prognosis. The cysts in few cases can be resolved after born. 7.8% of cases are biliary atresia with poor prognosis, which give messages to prenatal clinical consultation. Key words: Ultrasonography; Fetus; Hepatohilar cystic occupying lesions; Congenital biliary dilatation; Biliary atresia; Prognosis