Note: Items in bold represent most common diagnosis.

ABDOMINAL CYST OR FLUID COLLECTION

Dilated bladder

Dilated bowel

Hydroureter

Ovarian cyst (in females)

Renal cystic lesions, particularly ureteropelvic junction with anterior pelvis or pelvic dysplastic kidney

Adrenal cyst or hemorrhage

Choledochal cyst

Duodenal atresia, anal atresia, gut atresia

Enteric duplication cyst

Hepatic arteriovenous malformation

Hepatic cyst

Hydrometrocolpos

Liver cyst

Lymphangioma

Meckel’s diverticulum

Meconium pseudocyst

Mesenteric cyst

Rectal dilation

Sacrococcygeal (cystic) teratoma

Splenic cyst

Umbilical vein varix

Urachal cyst

ABDOMINAL WALL PROCESS

Omphalocele

Gastroschisis

Physiologic gut herniation (8 to 12 weeks’ gestation)

Limb–body wall complex

Umbilical hernia

Bladder exstrophy

Cloacal exstrophy (OEIS [omphalocele, exstrophy of the bladder, imperforate anus, and spinal defects] complex)

Pentalogy of Cantrell

Vesicoallantoic cyst

Urachal cyst

STOMACH NONVISUALIZATION

Diaphragmatic hernia (left sided)

Normal variant

Tracheoesophageal atresia or fistula/esophageal atresia

Microgastria

Central nervous system problems that prevent swallowing

Hiatal hernia

Facial cleft

Micrognathia

ASCITES (ISOLATED)

Renal obstruction

Trisomy 21

Meconium peritonitis

Fetal infections (especially parvovirus and cytomegalovirus)

DILATED STOMACH AND DUODENUM

Duodenal atresia

Normal variant

Annular pancreas

Antral web

Diabetic embryopathy

Gut malrotation

ECHOGENIC AREA IN ABDOMEN

ECHOGENIC MASS

Adrenal hemorrhage

Dysplastic second collecting system

Extralobar sequestration

Hepatic tumor

Neuroblastoma

Ovarian cyst with hemorrhage

Sacrococcygeal teratoma

Fetus in fetu

ECHOGENIC BOWEL

Cystic fibrosis

Intragut or intra-abdominal bleed

Meconium in the third trimester

Normal variant at term

Trisomy 21

Intrauterine growth restriction

Fetal infections (cytomegalovirus)

Meconium peritonitis

CALCIFICATION

Normal variant

Fetal infections (cytomegalovirus infection, toxoplasmosis)

Gallstones

Idiopathic arterial calcification

Teratoma (intrapelvic or in adrenal region)

Intraluminal calcification—imperforate anus/anal atresia

LARGE BOWEL DILATION

Anorectal malformation or atresia

Meconium plug syndrome

Hirschprung disease

OMPHALOCELE

Chromosome anomaly—trisomy 13, 18, or 21, triploidy

Isolated

Umbilical hernia

Amniotic band syndrome

Beckwith-Wiedemann syndrome

Carpenter syndrome

CHARGE association

Meckel-Gruber syndrome

Pentalogy of Cantrell

Short-rib polydactyly syndromes, various types

SMALL BOWEL DILATION

Jejunoileal atresia

Volvulus

Meconium ileus

Meconium peritonitis

Enteric duplications

Gastroschisis

Massive bilateral ureteropelvic junction obstruction

Cystic fibrosis

ABSENT BLADDER

Following voiding

Renal agenesis (bilateral)

Technical—obese patient and prone fetus

Bilateral renal dysplasia

Bladder exstrophy

Caudal regression

Cloacal exstrophy

Infantile polycystic kidney disease

Severe intrauterine growth restriction

Sirenomelia

Meckel-Gruber syndrome

CYSTS IN KIDNEYS

Multicystic dysplastic kidney

Severe hydronephrosis in single or double systems

Meckel-Gruber syndrome

Chromosomal—trisomy 13

Adult polycystic kidney

Ellis–van Creveld syndrome

Fryns syndrome

Infantile polycystic kidney disease

Jeune asphyxiating thoracic dystrophy

Joubert syndrome

Marden-Walker syndrome

McKusik-Kaufman syndrome

Orofacial-digital syndrome, various types (microcysts)

Roberts syndrome

Short-rib polydactyly syndromes, various types

Smith-Lemli-Opitz syndrome

Tuberous sclerosis

Zellweger syndrome

ENLARGED KIDNEYS OR KIDNEY

Autosomal recessive (infantile polycystic) kidney disease

Autosomal dominant (adult) polycystic kidney disease

Compensatory hypertrophy

Crossed renal ectopia

Double collecting system

Hydronephrosis

Multicystic dysplastic kidney disease

Beckwith-Wiedemann syndrome

Meckel-Gruber syndrome

Trisomy 13

Mesoblastic nephroma

GENITAL ABNORMALITIES

Smith-Lemli-Opitz syndrome

Campomelic dysplasia

Cloacal exstrophy

Chromosomal abnormalities, various

CHARGE association

Cornelia de Lange syndrome

Ectrodactyly-ectodermal-dysplasia-clefting (EEC) syndrome

Fanconi syndrome

Fraser syndrome

Noonan syndrome

Pallister-Killian syndrome

Pena-Shokeir syndrome

Short-rib polydactyly syndrome

Fryns syndrome

MURCS (müllerian duct aplasia, renal aplasia, cervicothoracic somite dysplasia)

HYDRONEPHROSIS ASSOCIATIONS

Ectopic ureter

Posterior urethral valves

Reflux

Ureterocele and ectopic ureter

Ureteropelvic junction obstruction

Ureterovesical junction obstruction

Bladder exstrophy

Cloacal exstrophy

Ectrodactyly-ectodermal-dysplasia-clefting (EEC) syndrome

Hemifacial microsomia (Goldenhar syndrome)

McKusik-Kaufman syndrome

Megacystis megaureter

Megacystis microcolon

Sacrococcygeal teratoma

POSSIBLE SUPRARENAL MASS

Adrenal hematoma

Multicystic duplicated collecting system

Extrapulmonary sequestration (left side)

Neuroblastoma

Hepatic mass

Liver cyst

RENAL AGENESIS

Isolated

VACTERL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, limb abnormalities) association

Caudal regression/sirenomelia

Diabetic embryopathy

Fraser syndrome (cryptophthalmos)

Hemifacial microsomia (Goldenhar syndrome)

Limb–body wall complex

MURCS (müllerian duct aplasia, renal aplasia, cervicothoracic somite dysplasia)

Short rib polydactyly

Townes-Brock syndrome

ENLARGED HEART

Cardiomyopathy

Hydrops

Anemia

Small chest (normal size heart appears large—dwarfing syndromes)

Bilateral atrioventricular valve regurgitation

Pronounced bradycardia

Severe mitral valve regurgitation

Pericardial effusion

LEFT HEART ENLARGEMENT

Aortic stenosis

Cardiomyopathy

RIGHT HEART ENLARGEMENT

Coarctation of the aorta (particularly relative to left heart)

Hypoplastic left heart syndrome (particularly if tricuspid regurgitation)

Dysplastic pulmonary valve syndromes (with severe pulmonary regurgitation)

Premature closure of the ductus (e.g., nonsteroidal anti-inflammatory drugs such as indomethacin and aspirin)

Tetralogy of Fallot

RIGHT ATRIAL ENLARGEMENT

Ebstein anomaly

Tricuspid regurgitation

Tricuspid stenosis

Total anomalous pulmonary venous return (left atrial hypoplasia so right atrium appears large)

BRIGHT ECHOES IN THE HEART

Chordae tendineae (normal variant)

Papillary muscle (normal variant)

Rhabdomyoma (tuberous sclerosis)

Dystrophic calcification syndrome

Angioma

Endocardial fibroelastosis (linear echogenic border to left ventricle)

Critical aortic stenosis and aortic atresia

Myocarditis (congenital infections—toxoplasmosis, cytomegalovirus)

CARDIAC ABNORMALITY ASSOCIATIONS

Chromosome abnormalities

Noonan syndrome

VACTERL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, limb abnormalities) association

Diabetic embryopathy

Deletion 22q syndrome (DiGeorge/velocardiofacial syndrome)

Adams-Oliver syndrome

Campomelic dysplasia

Cornelia de Lange syndrome

Cri-du-chat syndrome

Ellis–van Creveld syndrome (chondroectodermal dysplasia)

Fanconi syndrome

Fetal alcohol syndrome

Fetal infections

Hemifacial microsoma (Goldenhar syndrome)

Holt-Oram syndrome

Heterotaxy syndrome—situs inversus

Hydrolethalis

McKusik-Kaufman syndrome

Maternal phenylketonuria

Meckel-Gruber syndrome

Neu-Laxova syndrome

Retinoic acid embryopathy

Rubenstein-Taybi syndrome

Roberts syndrome

Short-rib polydactyly syndromes

Smith-Lemli-Opitz syndrome

Thrombocytopenia–absent radius syndrome (TAR)

Tuberous sclerosis (rhabdomyoma)

Williams syndrome

Zellweger syndrome

CARDIAC MASS

Rhabdomyoma (tuberous sclerosis)

Hypertrophic cardiomyopathy

Pericardiac masses (e.g., thymus, teratoma)

Basal cell nevus syndrome

PERICARDIAL EFFUSION

Infections

• 
  

  Cytomegalovirus

  
  
• 
  

  Parvovirus

  
  
• 
  

  Myocarditis

Valvular aortic stenosis (especially if mitral regurgitation is present)

Cardiomyopathy

Pronounced bradycardia

Tachycardia

Early sign of anemia—Rh, parvovirus, and α-thalassemia

Early sign of hydrops

Pericardial cyst

Normal echopenic rim (pseudopericardial effusion)

Cardiac tumor

Chromosomal—45X (Turner syndrome), trisomy 21

Confusion with pleural effusion

REVERSED ATRIAL SHUNT (LEFT ATRIUM TO RIGHT ATRIUM)

Critical mitral stenosis, mitral atresia

Severe left ventricular dysfunction

Severe left ventricular hypoplasia

Critical aortic stenosis/atresia

Hypoplastic left heart syndrome

REVERSED DUCTAL FLOW (AORTA-PULMONARY ARTERY)

Tricuspid atresia

Tetralogy of Fallot with severe pulmonary stenosis or atresia

Critical pulmonary stenosis or atresia

RETROGRADE FLOW IN THE AORTIC ARCH

Critical mitral stenosis, mitral atresia

Severe left ventricular dysfunction

Severe left ventricular hypoplasia

Critical aortic stenosis/atresia

Hypoplastic left heart syndrome

Interrupted aortic arch

ABSENT DUCTUS ARTERIOSUS

Tetralogy of Fallot/pulmonary atresia

Tetralogy of Fallot with dysplastic pulmonary valve syndrome

ABSENT DUCTUS VENOSUS

Underdevelopment or agenesis of the fetal portal system

• 
  

  Intrahepatic drainage—good prognosis

  
  
• 
  

  Extrahepatic drainage—potential for hydrops

BRADYCARDIA

Sinus node dysfunction

Atrioventricular node block (secondary or tertiary) (complete heart block)

Blocked premature atrial contractions

Structural heart abnormality

Maternal autoimmune disease

TACHYCARDIA

Sinus tachycardia

Supraventricular tachycardia

Atrial flutter

Atrial fibrillation with rapid ventricular response

Ventricular tachycardia

Sepsis

Anemia

Thyrotoxicosis

FLUID COLLECTION IN CHEST

Pleural effusion

Bronchogenic cyst

Congenital pulmonary adenomatoid malformation

Diaphragmatic hernia (stomach)

Bronchial atresia

Cystic hygroma

Duplication cyst

Enlarged cardiac chamber

Hiatal hernia (stomach)

Pericardial cyst

Mediastinal teratoma

Neuroenteric cyst

SOLID MASS IN CHEST

Congenital pulmonary adenomatoid malformation

Pulmonary sequestration

Cardiac tumor—rhabdomyoma

Chest wall hematoma

Mediastinal teratoma

Neuroblastoma metastases

Normal thymus

DIAPHRAGMATIC HERNIA ASSOCIATIONS

Fryns syndrome

Trisomy 18 and other chromosomal abnormalities

Pallister-Killian (tetrasomy 12p)

Jarcho-Levin syndrome

Deletion 4p (Wolf-Hirschhorn syndrome)

PLEURAL EFFUSION

Chylothorax

Early sign of hydrops

Trisomy 21

Hemothorax

Secondary to pulmonary sequestration, congenital pulmonary adenomatoid malformation, tracheal atresia

Lung agenesis

SMALL CHEST

Osteogenesis imperfecta type II

Thanatophoric dysplasia

Achondrogenesis, all types

Atelosteogenesis, all types

Campomelic dysplasia

Chondrodyoplasia punctata

Ellis–van Creveld syndrome (chondroectodermal dysplasia)

Fibrochondrogenesis

Hypophosphatasia

Jeune asphyxiating thoracic dystrophy

Multiple pterygium syndrome

Short-rib polydactyly syndromes, all types

Spondyloepiphyseal dysplasia congenita

AGENESIS OF THE CORPUS CALLOSUM ASSOCIATIONS

Dandy-Walker malformation, isolated

Aicardi syndrome

Acrocallosal syndrome

Apert syndrome

Chromosomal—trisomy 13

Chromosomal—trisomy 18

Encephalocele

Fetal alcohol syndrome

Fetal infections

Fryns syndrome

Hydrolethalus

Meckel-Gruber syndrome

Neu-Laxova syndrome

Smith-Lemli-Opitz syndrome

Walker-Warburg syndrome

Zellweger syndrome

BRAIN TOO EASILY VISUALIZED (UNDEROSSIFICATION OF BONE)

Osteogenesis imperfecta, type II

Achondrogenesis, some types

Acrania

Atelosteogenesis

Hypophosphatasia

Short-rib polydactyly syndrome

CEREBELLAR HYPOPLASIA

Dandy-Walker malformation

Spinal dysraphism

Chromosomal—trisomy 13

Chromosomal—trisomy 18

Cri-du-chat syndrome

Fetal infections

Joubert syndrome

Meckel-Gruber syndrome

Neu-Laxova syndrome

Smith-Lemli-Opitz syndrome

Walker-Warburg syndrome

DANDY-WALKER MALFORMATION

Cornelia de Lange syndrome