19例胎儿腹腔肿物产前及产后超声诊断分析

Analysis of Prenatal and Postpartum Ultrasound Diagnosis of Fetal Abdominal Mass in 19 Cases

目的:探讨产前及产后超声在胎儿腹腔肿物诊断中的应用价值。方法:回顾性分析19例产前及产后超声诊断腹腔肿物且有出生后手术病理结果的胎儿的声像图资料。结果:19例胎儿中,神经母细胞瘤3例,卵巢囊肿7例,大网膜囊肿1例,畸胎瘤3例,寄生胎1例,淋巴管瘤1例,肝脏婴儿型血管内皮瘤1例,先天性中胚层肾瘤1例,肠重复畸形1例。19例胎儿产前超声及产后超声诊断囊实混合性肿物6例,囊性肿物10例,实性肿物3例,对肿物囊实性质的诊断均与术中所见相符。产前超声共有4例给出了方向性的提示,其中与病理相符3例,分别为提示肿物性质为恶性、囊肿来源于卵巢、淋巴管瘤各1例。产后超声共有12例给出了方向性的提示,其中9例与病理相符,分别提示为神经母细胞瘤3例、畸胎瘤1例、囊肿来源于卵巢4例、淋巴管瘤1例。结论:产前以及产后超声可以对胎儿腹腔肿物的囊实性质进行准确的诊断并且可以综合肿物发生部位以及典型的回声特征等信息对肿物进行方向性提示,产后超声的方向性提示与病理结果的符合率更高。产前及产后的超声评估,对临床的下一步诊疗决策有重要指导意义。

Objective： To explore the value of prenatal and postpartum ultrasonography in the diagnosis of fetal abdominal mass.Methods： Retrospective analysis of the audiovisual data was performed in 19 cases diagnosed as fetal abdominal mass by prenatal and postpartum ultrasound and with the results of postnatal pathological data.Results： In the 19 cases,three were confirmed as neuroblastoma,seven as ovarian cyst,one as omental cyst,three as teratoma,one as parasitic fetus,one as lymphangioma,one as infantile hemangioendothelioma of liver,one as congenital mesoblastic nephroma and one as intestinal duplication. In all cases,six were diagnosed by prenatal and postpartum ultrasonography as mixed mass,10 cases as cystic mass and three cases as solid mass.The diagnosis was consistent with the intraoperative findings.Prenatal ultrasound was used for directional diagnosis of four cases,three of which were in conformity with the pathology outcomes（ malignant tumor,ovarian cyst and lymphangioma respectively）. Postpartum ultrasound was used for directional diagnosis of 12 cases,nine of which were in conformity with the pathology outcomes.Among them,three cases were diagnosed as neuroblastoma,one as teratoma,four as ovarian cyst and one as lymphangioma.Conclusions： The properties of fetal abdominal mass could be determined by the prenatal and postpartum ultrasonography accurately.Predictions could be made by ultrasonography combined with the information such as the location of the mass and the typical echogenicity.Postpartum ultrasonography showed a higher concordance with pathological results.The prenatal and postnatal ultrasound evaluations are of great significance to the clinical decision-making.