胎儿先天性肺囊腺瘤超声诊断价值

The Value of Ultrasound in Diagnosis of Fetal Congenital Cystic Adenomatoid Malformation

目的:探讨胎儿先天性肺囊腺瘤的超声诊断价值,并对预后进行分析。方法:2007年1月-2014年3月,对本院产前超声诊断为胎儿先天性肺囊腺瘤的11例孕妇进行观察,重点扫查胎儿双侧肺,观察病灶二维超声声像图特征,应用彩色多普勒显示病灶血供情况,并注意观察有无胎儿水肿和其他胎儿异常畸形存在,随访临床、影像或病理检查结果。结果:检出的11例胎儿先天性肺囊腺瘤中,10例病灶位于单侧肺,1例病灶双侧肺均有;单侧肺病例中,6例位于左侧,4例位于右侧;Ⅰ型3例,Ⅱ型5例,Ⅲ型3例;4例伴有羊水过多;2例Ⅲ型伴有胎儿水肿;1例Ⅱ型伴有同侧胸腔少量积液及合并胎儿唇裂畸形;2例Ⅱ型定期复查显示病灶逐渐缩小;1例Ⅰ型出生后经手术治疗,术后患儿如常;7例选择终止妊娠,引产后病理证实与超声诊断相符。结论:产前超声检查能准确诊断胎儿先天性肺囊腺瘤畸形,可对病灶进行分型并评估预后。

Objective： To explore the value of ultrasound in diagnosis of fetal congenital cystic adenomatoid malformation, and analyze the prognosis. Method： From 2007 January to 2014 March, 11 gravidas who were diagnosed as fetal congenital cystic adenomatoid malformation through prenatal ultrasound were observed, the fetal lung lesions, the two-dimensional ultrasound characteristics were scanned as a key point, and the blood supply were observed by using color Doppler,the hydrops fetalis and other fetal malformation were also observed, the clinical symptom, pathology and imageology result were observed as follow-up data. Result： Within the 11 cases with congenital pulmonary cystadenoma, 10 cases with unilateral lung pathology（6 left, 4 right） and 1 case with bilateral lung pathology. 3 cases of type Ⅰ, 5 cases of type Ⅱ, 3 cases of type Ⅲ were identyfied. 4 cases with polyhydramnios, 2 cases with hydrops fetalis, 1 case of the type Ⅱ with slight hydrothorax in the same side combine with fetal lagocheilus were found, 2 case of type Ⅱ showed a shrinking lesions in the periodic inspection, 1 case of type Ⅰ was cured by surgery postnatally, 7 cases chose pregnancy termination and the post-odinopoeia pathology conformed to ultrasound diagnosis. Conclusion： Prenatal ultrasonography is not only effective in the diagnosis of fetal congenital cystic adenomatoid malformation of the lung lesions, but also in the classification of pathology and the assessment of prognosis.