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© 2004 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 23:483-488 • 0278-4297

Isolated Echogenic Foci in the Left Upper Quadrant of the Fetal Abdomen

Are They Significant?

Eun-Kyung Ji, MD, Eun Kyung Lee, MD and Tae Hee Kwon, MD

Departments of Diagnostic Radiology (E.-K.J., T.H.K.) and Pediatrics (E.K.L.), Cha General Hospital, College of Medicine, Pochon Cha University, Seoul, South Korea.

Address correspondence and reprint requests to Eun-Kyung Ji, MD, Department of Diagnostic Radiology, Cha General Hospital, College of Medicine, Pochon Cha University, 650-9 Yuksam-Dong, Kangnam-Gu, Seoul 135-080, South Korea. E-mail: jiekkorea{at}hanmail.net.

Objectives. To evaluate fetuses with echogenic foci in the left upper quadrant of the abdomen by sonographic examination. Methods. Between November 2000 and October 2001, we prospectively assessed fetuses with echogenic foci in the abdominal left upper quadrant on routine prenatal sonography. The location, number, and size of the foci were analyzed, and in utero and postpartum follow-up scans were performed. A pediatrician evaluated the perinatal outcome. Results. Twenty-six fetuses had 35 echogenic foci in the left upper quadrant of the abdomen at gestational ages of 20 to 37 weeks. The locations of the foci along the stomach, spleen, and the left lobe of the liver were found on sonography and measured 2 to 5 mm. Of the 16 fetuses who had follow-up scans in utero, 7 had disappearance of the foci. Postpartum follow-up scans were performed in 12 cases. Among them, 9 neonates had no lesions, and 3 had echogenic foci of a size and appearance similar to those seen prenatally in the left lobe of the liver. Only 1 of 4 patients who had TORCH (toxoplasmosis, other, rubella, cytomegalovirus, and herpes simplex) titers evaluated had elevated immunoglobulin G levels; no patient had any sign of infection after birth. All fetuses had a normal postnatal outcome. Conclusions. Many echogenic foci in the left upper quadrant of the fetal abdomen will disappear, and the outcome is promising even when the lesion persists after birth.

Key Words: fetus, abnormalities • fetus, gastrointestinal tract • fetus, infection • fetus, sonography

Abbreviations: LUQ, left upper quadrant • TORCH, toxoplasmosis, other, rubella, cytomegalovirus, and herpes simplex

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Copyright © 2004 by the American Institute of Ultrasound in Medicine.