实时三维超声对胎儿先天性肺囊腺瘤畸形的诊断及预后评价

Diagnosis and Prognosis Evaluation of Real-time Three-dimensional Ultrasound on Fetal Congenital Cystic Adenomatoid Malformation of the Lung

目的:研究并探讨实时三维超声对胎儿先天性肺囊腺瘤畸形的诊断价值。方法:收集2013年1月-2015年12月60例产前实时三维超声诊断为疑似胎儿先天性肺囊腺瘤畸形的孕妇病例资料进行回顾性研究,对其超声表现进行分析,并与引产后尸检和出生后超声诊断结果进行对照,分析先天性肺囊腺瘤胎儿的预后情况。结果:经引产后尸检与出生后超声证实,60例产前实时三维超声诊断为疑似先天性肺囊腺瘤的胎儿中,共有57例胎儿确诊为先天性肺囊腺瘤畸形,其诊断符合率为95.00%,误诊3例,其误诊率为5.00%,与确诊结果之间的一致性良好。共19例孕妇选择终止妊娠,17例胎儿经尸检证实;41例孕妇选择继续妊娠,40例胎儿经超声证实。共有8例胎儿在出生后1个月内因呼吸衰竭死亡,其余33例胎儿出生后至今均未出现任何呼吸系统症状。结论:采用实时三维超声可对胎儿先天性肺囊腺瘤畸形予以准确的诊断,有利于减少先天性肺囊腺瘤畸形胎儿的出生,并对其预后进行有效评价。

Objective： To study and explore the value of real-time three-dimensional ultrasound diagnosis of fetal congenital cystic adenomatoid malformation of the lung.Method： 60 cases of prenatal diagnosis of suspected real-time three-dimensional ultrasound of fetal congenital cystic adenomatoid malformation of the lung from January 2013 to December 2015 were collected to retrospective study, the ultrasound findings were analyzed and compared with the result of fault diagnosis of ultrasound and birth autopsy after induced abortion, and analyzed the prognosis of congenital pulmonary cystadenoma of the fetus.Result： After induction of labor autopsy and postnatal ultrasound confirmed, 60 cases of prenatal diagnosis of congenital pulmonary cystadenoma with real-time three-dimensional ultrasound, a total of 57 cases of congenital malformation of the lung, the diagnostic coincidence rate was 95.00%, 3 cases were misdiagnosed, the misdiagnosis rate was 5.00%, good agreement with the results of diagnosis. A total of 19 pregnant women were selected to terminate the pregnancy, and a total of 17 fetuses were confirmed by autopsy; 41 pregnant women chose to continue pregnancy, the fetus was confirmed by ultrasound in 40 cases.A total of 8 fetuses died of respiratory failure within 1 month after birth, the remaining 33 cases of fetal birth had not appeared any respiratory symptoms.Conclusion： The use of real-time three-dimensional ultrasound can accurately diagnose fetal congenital pulmonary cystadenoma malformation, which is helpful to reduce the birth of congenital pulmonary cystic malformation fetus, and to evaluate the prognosis.