产前彩超在胎儿胸部发育异常诊断中的应用价值

The application of prenatal color Doppler ultrasonography in fetal chest dysplasia

目的探讨产前彩超检查诊断胎儿胸部发育异常的临床应用价值。方法对我院2006年6月至2016年6月就诊的208例发现胎儿胸部发育异常者进行回顾性分析,总结声像图表现及诊断要点,并进行产后跟踪随访或行胎儿尸检。结果产前超声检出的208例胎儿均经分娩或引产证实。胎儿隔离肺12例,病灶均为单侧,其中左侧7例,右侧5例;先天性肺囊性腺瘤畸形42例,双侧1例,为Ⅱ型,单侧41例,其中Ⅰ、Ⅱ、Ⅲ型各为5、16、20例;先天性膈疝35例,34为左侧,1例为右侧;小胸廓畸形10例;胸裂6例;胸腔积液95例,单纯性10例,伴发其它异常85例;纵隔肿瘤1例,产后诊断淋巴管囊肿;胸腺增大7例。结论产前彩超检查对胎儿胸腔发育异常有关键诊断价值,观察胎儿是否合并其它畸形,密切追踪后期病变进展,为临床采取最佳处理措施提供事实依据。

Objective：To analyze the clinical value of color Doppler ultrasonography in fetal chest dysplasia. Methods：We studied 208 pregnant women diagnosed with fetal chest dysplasia between June 2006 and June 2016 by retrospective analysis. The major points of sonographic character were summarized,and compared with the results of the clinical diagnosis after delivery or autopsy. Results：Total of 208 cases of fetus diagnosed by prenatal ultrasound were confirmed by delivery or induced abortion. There were 12 cases of pulmonary sequestration which were unilateral,including left side in 7 cases and right side in 5 cases;42cases of congenital cystic adenomatoid malformation,1 case on both sides for type Ⅱ,41 cases on one side including 5、16、20cases for type Ⅰ,Ⅱ,Ⅲ respectively;35 cases of congenital diaphragm hernia including left side in 34 cases and right side in 1case;10 cases of congenital small chest deformity;6 cases of thoracoschisis;95 cases of pleural effusion in which 10 cases just as simple,and 85 cases with other abnormalities;1 case of mediastinal tumor which was diagnosed as cystic hygroma after deliver;7 cases of thymic enlargement. Conclusion：Prenatal ultrasonography has the key diagnostic value for fetal chest dysplasia. Along with detailed observation of the fetus and closely prenatal follow-up,it can provide the best treatment measures for the clinicians.