胎儿胸腔占位性病变的产前超声诊断及其预后分析

Diagnosis by prenatal ultrasound and prognosis of fetal thoracic occupying lesions

目的探讨产前超声诊断胎儿胸腔占位性病变的临床应用价值及其转归和预后。方法对2012年1月—2016年11月海军总医院超声医学科常规产前超声筛查怀疑胎儿胸腔占位性病变的45例胎儿行进一步系统超声检查,重点观察胎儿胸腔占位性病变的来源、部位、病变的回声特征和血供情况等,并注意观察有无胎儿水肿和其他结构异常,初次检出孕周为20~35周,孕妇年龄22~42岁。结果在检查的45例胎儿胸腔占位性病变中,先天性肺囊腺瘤样畸形13例(13/45,28.90%),隔离肺10例(10/45,22.22%),先天性膈疝11例(11/45,24.44%),胸腔积液10例(10/45,22.22%),心脏肿瘤1例(1/45,2.22%)。胎儿胸腔占位性病变多发生在左侧,7例隔离肺和5例胸腔积液随孕周增加病灶逐渐缩小或消失,先天性膈疝多合并其他结构和染色体异常,先天性肺囊腺瘤样畸形出生和引产各半,染色体异常共5例(5/45,11.11%)。结论产前彩色多普勒超声诊断胎儿胸腔占位性病变和评估预后有重要价值。

Objective To investigate the clinical value and prognosis of fetal thoracic space occupying lesions by prenatal ultrasound diagnosis.Methods From January2012to November2016,routine prenatal ultrasound screening for suspected fetal pleural ultrasonography with45fetu?ses for further system lesions,locus on the observation ol the fetal thorax occupying source,lesion site,lesion echo characteristics and blood supply,and observe whether fetal edema and other struc?tural abnormalities existed.The initial detection for20-35weeks of gestation,pregnant women aged22-42years.Results Forty-five fetal pleural lesions in13fetuses(13/45,28.90%)for congeni?tal cystic adenomatoid malformation(CCAM),10fetuses(10/45,22.22%)for pulmonary seques?tration(PS),11fetuses(11/45,24.44%)for congenital diaphragmatic hernia(CDH),10(10/45,22.22%)for fetal pleural effusion(PE),and1(1/45,2.22%)for fetal cardiac tumors.Fetal pleural lesions usually occurred on the left side,7fetuses PS and5fetuses PE lesions gradually shrink or disappear with the increase of gestational age,CDH combined with other structural and chromosomal abnormalities,and induction of CCAM was born in half,a total of5fetuses chromo?somal abnormalities(5/45,11.11%)screened.Conclusion Prenatal color doppler ultrasonography is of great value in the diagnosis of fetal space occupying lesions and evaluation of prognosis.