探讨胎儿肝强回声变化规律和病因，为临床咨询提供帮助。

采用回顾性研究方法，收集自2016年1月1日至2019年12月31日在首都医科大学附属北京妇产医院和首都医科大学附属北京潞河医院产前超声检查发现胎儿肝存在强回声灶的单胎孕妇63例。记录孕妇基本信息，胎儿大小测值，强回声病灶的大小、位置、数量，是否合并胎儿其他结构异常，胎盘、羊水、脐带、胎儿脐动脉血流等情况。随访入组病例的染色体检查结果及母体病毒系列（TORCH）检查结果及胎儿强回声灶随孕周的变化及妊娠结局。所有活产婴儿都详细记录新生儿出生信息，出生后生长发育及肝超声复查情况。总结、整理产前产后资料，探讨肝强回声变化特征和病因。采用秩和检验比较出生后回声消失与否2组病例的出生前病灶长径的差异。

63例胎儿中合并胎儿其他结构异常者17例（27%，17/63），孤立性肝强回声灶46例（73%，4/63）；染色体异常2例（3%，2/63），均为21-三体；母体病毒感染3例（5%，3/63）；胎粪性腹膜炎1例（2%，1/63）。17例合并胎儿其他结构异常的病例中有2例终止妊娠，1例新生儿死亡，2例生后接受手术治疗。共随访到52例生后信息：27例出生时强回声灶仍存在，出生前病灶平均长径为0.70 cm，中位数为0.60（0.60，0.80）cm，25例出生时已消失，出生前病灶平均长径为0.47 cm，中位数为0.50（0.40，0.60）cm，二者差异具有统计学意义（Z=3.54，P＜0.001）。所有活产病例结局均良好。

胎儿肝强回声灶并不罕见，部分胎儿肝强回声灶（长径较小）可自发消失。孤立性病灶病例占比比既往文献高，且预后良好。母体病毒感染主要为巨细胞病毒感染。当合并胎儿其他结构异常时，建议通过无创DNA或羊水穿刺进行胎儿染色体检查，必要时还需进行染色体微阵列分析。

To explore the pattern of the changes and etiology of fetal liver strong echo by analyzing the ultrasonographic features, in order to provide help for clinical consultation.

A retrospective study was conducted on 63 singleton pregnant women who were found to have strong echo in fetal liver on ultrasound examination at Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University and Beijing Luhe Hospital Affiliated to Capital Medical University from January 1, 2016 to December 31, 2019. The basic information of pregnant women, fetal measurement results, the size, shape, location, and number of fetal liver strong echoes, whether there were other fetal structural abnormalities, placenta, amniotic fluid, umbilical cord, and fetal umbilical artery blood flow were recorded. The results of chromosome examination and maternal virus series (TORCH) examination, the changes of fetal strong echo during pregnancy, and the pregnancy outcome of the included cases were followed. Neonatal birth information, post-birth growth, and strong echo reexamination of the liver were recorded in all live births. The etiology and pattern of changes of strong echo in fetal liver were explored by summarizing prenatal and postnatal data. The rank sum test was used to compare the difference in the length of prenatal lesions between the two groups with or without strong echo after birth.

Among the 63 fetuses, 17 (27%, 17/63) were associated with other fetal abnormalities, and 46 (73%, 46/63) had isolated fetal liver strong echo. Chromosome abnormality was found in two cases (3%, 2/63), and both had trisomy 21. Three pregnant women had viral infections (5%, 3/63). Meconium peritonitis occurred in one case (2%, 1/63). Among the 17 cases associated with other fetal abnormalities, two terminated pregnancy, one had neonatal death, and two received surgical treatment after birth. The postnatal information of 52 cases was followed, of which 27 still had strong echo at birth, the mean lesion length was 0.70 cm, and the median was 0.60 (0.60, 0.80) cm. The strong echo had disappeared at birth in the remaining 25 cases, the mean lesion length was 0.47 cm, and the median was 0.50 (0.40, 0.60) cm; the difference was statistically significant between the two groups (Z=3.54, P＜0.001). All live births had good outcomes.

Fetal liver strong echo are not uncommon, and some fetal liver strong echoes (smaller in length) may disappear spontaneously. The proportion of cases with isolated foci is higher than that reported in the previous literature, and the prognosis is good. Cytomegalovirus infection is the main infection. When there are other abnormalities in the fetus, it is recommended to conduct fetal chromosome examination through non-invasive DNA or amniocentesis, and to conduct chromosome microarray analysis if necessary.