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目的探讨产前超声对胎儿胸腔病变的诊断价值及临床意义。方法回顾性分析该院产前超声诊断的32例胎儿胸腔病变的声像图特征及临床资料,并进行产前及产后追踪随访或行胎儿尸检。总结其彩色多普勒声像图表现特征及其临床意义。结果产前超声共诊断胎儿隔离肺(PS)6例,病灶均为单侧,其中左侧5例,右侧1例,包块直径2.2~5.2 cm。先天性肺囊性腺瘤畸形(CCAM)8例,其中Ⅰ、Ⅱ、Ⅲ型各为3、3、2例,1例Ⅲ型者产前被误诊为PS。先天性膈疝(CDH)3例,均为左侧,其中2例合并有其他畸形,1例经染色体检查诊断为18三体综合征,3例胎儿均引产。胸腔积液11例,单纯7例,双侧4例,8例引产。小胸廓畸形3例,均引产后证实;纵隔畸胎瘤1例。结论产前超声检查对胎儿胸腔病变有特异性表现,无创、价廉,可动态随访观察,对诊断、追踪及预后判断均具有重要临床意义。
Objective To investigate the diagnostic value and clinical significance of prenatal ultrasound in fetal pleural lesions. Methods Retrospective analysis of the prenatal ultrasound diagnosis of 32 cases of fetal pleural lesions of the sonographic features and clinical data, and follow-up of prenatal and postnatal follow-up or fetal autopsy. Summary of its color Doppler imaging features and clinical significance. Results Prenatal ultrasound was used to diagnose 6 cases of fetal isolated lung (PS). All the lesions were unilateral, of which 5 were on the left and 1 was on the right. The diameter of the mass was 2.2-5.2 cm. Congenital cystic adenoma of the lung (CCAM) in 8 cases, of which Ⅰ, Ⅱ, Ⅲ type of 3,3,2 cases, 1 case of type Ⅲ prenatal misdiagnosed as PS. Congenital diaphragmatic hernia (CDH) in 3 cases, both on the left, including 2 cases with other deformities, 1 case of chromosome diagnosis of trisomy 18, 3 cases of fetus were induced. Pleural effusion in 11 cases, simple in 7 cases, bilateral in 4 cases, 8 cases of induced labor. Small thoracic deformity in 3 cases, all confirmed after induction of labor; 1 case of mediastinal teratoma. Conclusion Prenatal ultrasonography has specific performance on fetal pleural disease. Noninvasive, inexpensive and dynamic follow-up observation is of great clinical significance for diagnosis, follow-up and prognosis.