EP06.30: “EchoGem” novel ultrasound sign for hepatic hemangiomas: a single‐centre case series

Hepatic vascular malformations include hemangiomas, arteriovenous malformations and venous malformations. The aims of this study was to introduce a novel ultrasound sign “Echogem” as a reliable feature for identifying hemangiomas. This sign helps differentiating them from AV malformations and helps decide antenatal and postnatal course. Four cases of liver hemangiomas between 20-37 weeks of gestation were seen for 2D and Doppler characteristics. Diagnosis relied on identifying a mixed echogenic lesion with a central echogenic core and peripheral hypoechoic rim (“Echogem”). All cases screened for fetal anemia and echocardiography performed for signs of cardiac decompensation. MRI and follow up done antenatally. Postnatal monitoring was performed. Two cases presented at anomaly scan with classical sign “Echogem” showed antenatal regression (see figures 1,2). Third case at 35 weeks showed postnatal regression (see figure 3). Fourth case with first visit at 25 weeks showed “Echogem” sign and measured 3.2x1.8 x1.7cm. Patient did not come for follow up and revisited at 36 weeks showing threefold increase in size of lesion measuring 11.7x8.3x9.1cm showing displacement of intraabdominal structures and features of volume overload (see figure 4). Immediate LSCS performed and baby managed medically. Our study emphasises importance of ultrasound in fetal hepatic vascular malformations, with focus on hemangiomas. Introduction of “Echogem” as a novel feature aiding diagnosis of hemangiomas and guiding antenatal and postnatal management. 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.