胎儿腹腔内隔离肺的产前超声诊断及临床价值

Prenatal diagnosis of intraabdominal extralobar pulmonary sequestration by ultrasound

目的探讨产前超声对腹腔内隔离肺的诊断价值及临床意义。方法回顾性分析3例本院诊断及43例文献报道胎儿腹腔内隔离肺的临床资料、超声检查特征、处理及预后。结果46例腹腔内隔离肺产前诊断的平均孕龄为（24．5±5．9）周，男女比例约（3-4）：1，78．3％（36／46）的肿块位于左侧，47．8％（22／46）呈均质高回声，8．7％（4／46）合并畸形，78．3％（36／46）实行早期手术治疗且预后良好。15．2％（7／46）于产前经彩色多普勒识别供血动脉，且经手术或解剖证实。结论产前超声对胎儿腹腔内隔离肺具有重要的诊断价值，彩色多普勒识别供血动脉是诊断腹腔内隔离肺的重要指标。手术切除腹腔内隔离肺预后良好。

Objective To describe the diagnostic approach and clinical outcomes of fetal intraabdominal extralobar pulmonary sequestration （IEPS）. Methods Three cases of IEPS were diagnosed prenatally by ultrasound in our center. The data of these 3 cases and 43 cases in prior studies from 1986 to 2016 were retrospectively reviewed. The prenatal sonographic features, treatment, and outcomes were collected. Results The gestational age of diagnosis IEPS was （24.5 ± 5.9）weeks, the male-to-female ratio was 3-4 ： 1, 78.3%（36/46） of IEPS masses located on the left side, 47.8% （22/46） of lesions were homogenous and hyperechoic, 8.7 % （4/46） of cases associated anomalies, 78.3% （36/46） of patients were preformed resection and postoperative recovery and subsequent course were uncomplicated. Feeding arteries were detected in 15.2% （7/46） cases and confirmed by surgery or autopsy. Conclusions Prenatal ultrasound has the diagnostic accuracy of IEPS. Feeding arteries noted on color Doppler are strongly indicators of IEPS. Postsurgical outcomes are favorable.