胎儿肝脏血管瘤的产前超声影像学特征及预后

Prenatal Ultrasound Imaging Features and Prognosis of Hepatic Hemangioma

【目的】探讨胎儿肝脏血管瘤的产前超声影像学特征及预后。【方法】回顾性分析2014年1月至2018年10月在本院产前超声检查发现的胎儿肝脏实性肿块且产后证实为肝脏血管瘤的患者15例,分析产前超声影像学特征,并追踪其预后。【结果】15例病例中13例产前超声提示胎儿肝内血管瘤,2例误诊为肝母细胞瘤(其中1例引产、1例活产分娩),产前超声诊断正确率为86.7%(13/15)、误诊率为13.3%(2/15);15例中2例为高回声、1例为等回声、5例为低回声、7例为混合回声;15例中13例活产分娩、2例引产,13例活产婴儿经彩色多普勒超声或增强CT扫描或MRI检查证实为肝血管瘤,2例引产胎儿在孕妇知情同意的前提下经尸体解剖及病理检查证实为肝血管瘤。13例活产婴儿均采取保守治疗,治疗期间行彩色多普勒超声随访观察6~36个月,均预后良好。【结论】胎儿肝脏血管瘤的边界、内部回声、血流信号等有一定特点,但是缺乏特异性,产前超声对胎儿肝脏血管瘤的诊断有一定价值,肝血管瘤患儿经保守治疗预后良好。

【Objective】To investigate the prenatal sonographic characteristics and prognosis of the hepatic hem angiomas.【Methods】We retrospectively reviewed the sonographic images of 15 patients with hepatic hemangiomas from January 2014 to October 2018 during our hospital.Prenatal liver hemangiomas ultrasound imaging features and prognosis were analyzed.【Results】Of the 15 cases,13 were diagnosed as hepatic hemangioma by prenatal ultrasound,and 2 were misdiagnosed as hepatoblastoma(1 case was induced and 1 case was delivered by live birth).The diagnostic accuracy of prenatal ultrasound was 86.7%(13/15),and the misdiagnosis rate was 13.3%(2/15).The echogenicity of hemangioma included hyperechoic(2/15),isoechoic(1/15),hypoechoic(5/15),mixed echo(7/15).The 13 live births were confirmed to have hepatic hemangioma by color Doppler ultrasound or enhanced CT scan or MRI;while 2 induced fetuses were confirmed hepatic hemangiomas by autopsy and pathology on the premise of informed consent of pregnant women.All 13 live-bom infants were treated conservatively and performed color Doppler ultrasound during treatment with good prognosis for 6~36 months follow-up.【Conclusion】Fetal hepatic hemangioma has certain characteristics such as boundary,internal echo,and blood flow signals,however,it lacks specificity.Prenatal ultrasound can provide some values in the diagnosis of fetal hepatic hemangioma.Children with hepatic hemangioma have a good prognosis after conservative treatment.