胎儿皮肤血管瘤的超声诊断及监测

Prenatal ultrasonoic diagnosis and monitoring to fetal cutaneous hemangioma

目的描述胎儿皮肤血管瘤的超声图像特征及围产期自然进程。方法对超声检查发现胎儿皮肤肿物的病例进行观察、监测、随访,回顾分析6例明确诊断为血管瘤的声像图特征、监测过程、并发症情况及妊娠结局。结果 6例血管瘤均为实质性回声,彩色多普勒超声显示内部血流信号丰富3例,其中胎儿出现心衰伴羊水过多及脐动脉S/D升高2例、周围结构受侵2例,3例胎儿均引产;肿块内血流信号由丰富变为稀疏1例,伴随羊水过少及脐动脉S/D升高,最终胎死宫内;血流信号稀疏的2例胎儿孕程中均未出现合并症,新生儿存活。结论对胎儿皮肤血管瘤有序、全面的评估展示了进展的超声表现,丰富了对疾病的认识。

Objective：To describe the ultrasonic characteristics of fetal cutaneous hemangioma and perinatal natural processes. Methods：The cutaneous masses were serially surveilled. The sonographic findings were analyzed,compared with the result of the clinical outcome. Results：The ultrasonogram of 6 cases presented as a solid-echo. Color doppler sonography showed profuse blood flow（3 cases）,in these 2 cases cardiac failure following hydramnion and abnormality S/D（UA）,2 cases surrounding tissue invaded. finally 3 fetuses was induced;One fetus that blood flow changed from profuse to rare,following oligohydramnios and abnormality S/D（UA）died in the uterus;Rare blood flow（2 case）did not develop any perinatal complications by ultrasound,and the neonates had favourable prognosis. Conclusions：Sequential evalvation of the cutaneous hemangioma showed an evolving ultrasound appearance which reinforced our initial impression.