Clínica de Diagnóstico por Imagem (CDPI) & Instituto Fernandes Figueira (IFF) – FIOCRUZ - Rio de Janeiro – Brazil

The calcifications in the liver may be vascular (ischemic hepatic necrosis), capsular (bowel perforation with meconium peritonitis, most common cause) or intraparenchymal (systemic process, may be related to toxoplasmosis or cytomegalovirus). Acoustic shadow may or may not be present. The prognosis will depend on the etiology. When isolated, they probably have little clinical significance.

This is a fetus with isolated hepatic calcifications. No other associated anomalies were seen. The cytomegalovirus, toxoplasmosis and cystic fibrous test were negative. The diagnosis was performed at 26 weeks . The baby girl was delivered by cesarean section at 38 weeks (3050 g and Apgar 9/10). The postnatal MRI reported a normal liver.

Axial ultrasound (26 weeks) showing multiple hyperechoic foci within the fetal liver (arrows). Acoustic shadow may or may not be present.

Left image: Axial view showing calcifications along the liver (arrows). Right image: Postnatal image (3 days) showing the liver calcifications.

Postnatal MRI showing normal liver.

References
• Bronshtein M et al.: Prenatal diagnosis of liver calcifications. Obstet Gynecol 86(5): 739-43,1995.
• Simchen MJ et al.: Fetal hepatic calcifications: prenatal diagnosis and outcome. Am J Obstet Gynecol 187(6): 1617-22, 2002.