产前超声诊断胎儿肝脏肿瘤临床分析

Clinical Analysis of Fetal Hepatic Tumors Prenatal Diagnosed by Ultrasonic Testing

目的探讨产前超声诊断胎儿肝脏肿瘤的价值。方法对孝感医院于2005年6月-2011年11月确诊为肝脏肿瘤的8例胎儿进行回顾性分析,运用产科系统超声检查方法详细检查每例胎儿,对肝脏肿瘤的大小、部位、形态、内部回声及血流分布进行观察,并进行追踪随访。结果 8例胎儿肝脏肿瘤均为单发。其中肝脏海绵状血管瘤6例,肝母细胞瘤2例,均经引产后病理证实或产后手术证实。8例肝脏肿瘤边界均较清晰,形态较规则,6例肝脏海绵状血管瘤中,3例位于肝右叶,3例位于肝左叶;5例为低回声团,1例为不均高回声团;4例血流信号较丰富,2例见少许血流信号。2例肝母细胞瘤均位于肝右叶,血流信号均较丰富,1例为实性低回声,另1例为不均高回声。8例胎儿肝脏肿瘤产前均未能明确定性。结论胎儿肝脏肿瘤超声表现较复杂,产前超声较易检出胎儿肝脏肿瘤,但不易鉴别肿瘤性质。

Objective To study the diagnostic value of prenatal ultrasonic testing in fetal hepatic tumors.Methods Eight fetuses with hepatic tumors were detected by prenatal ultrasound between July 2005 and November 2011 in our hospital.Each fetus was examined carefully by prenatal ultrasound and followed up.The ultrasonographic information（such as the size,shape,location,echogenic type and blood vessels distribution of tumors） was analyzed retrospectively.Results The hepatic tumors in the 8 fetuses were all detected prenatally.All of 8 fetal hepatic tumors were unifocal,6 of which were cavernous hepatic hemangioma,2 were hepatoblastomas.The definitive diagnosis was confirmed by histopathological examination.The 8 tumors were well-defined,with regular shape.In 6 cases of hemangioma,3 cases were in the right lobe of the liver,3 were in the left lobe of the liver.5 cases were with hypoechoic,1 case was hetero-generous hyperechoic tumor,and 4 with abundant vascularization,2 with less vascularization.The 2 cases of hepatoblastoma were both in the right lobe of the liver,both with abundant vascularization,and one was hypoechoic mass,the other was hetero-generous hyperechoic mass.The definitive diagnosis of 8 tumors was not made antenatally.Conclusion Fetal hepatic tumors can be detected easily by prenatal ultrasonic testing.But the ultrasonographic appearances of fetal hepatic tumors are complex,and are difficult to make the definitive diagnosis antenatally.