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目的探讨胎儿支气管源性囊肿的产前超声声像图特征,分析漏误诊原因。方法分析12例支气管源性囊肿的临床资料和超声声像图特征。结果 12例胎儿出生后手术及病理证实为支气管源性囊肿,纵隔型8例(其中3例合并肺囊腺瘤样畸形),肺内型3例(其中1例合并肺隔离症),异位型1例(合并肺隔离症)。7例产前超声发现了支气管源性囊肿病灶;4例只发现了肺内合并的病灶,漏诊了肺外的支气管源性囊肿病灶;1例产前超声未发现病灶。在产前超声发现的7例胎儿中,单发囊性病灶5例,囊实性病灶2例;3例诊断为支气管源性囊肿,诊断符合率25%,4例误诊为肺囊腺瘤样畸形。结论胎儿支气管源性囊肿容易合并肺囊腺瘤样畸形、肺隔离症,产前超声明确诊断有一定的困难。产前超声的价值在于发现并定位病灶,同时评估肿块对肺组织、气管的压迫及纵隔移位的情况。
Objective To investigate the characteristics of prenatal ultrasound sonography of fetal bronchogenic cysts and analyze the causes of misdiagnosis. Methods Clinical data and sonographic features of 12 cases of bronchogenic cysts were analyzed. Results Twelve fetuses were confirmed as bronchogenic cysts by operation and pathology. There were 8 cases of mediastinal type (including 3 cases of pulmonary cystadenomatoid deformity), 3 cases of pulmonary type (1 case of pulmonary sequestration), ectopic 1 case (combined with pulmonary sequestration). Seven cases of bronchogenic cyst lesions were found by prenatal ultrasound, four cases of combined lesions in the lung, four cases of bronchogenic cysts outside the lung were missed, and one case of prenatal ultrasound was not found. Among the 7 fetuses found in prenatal ultrasound, 5 were single cystic lesions and 2 were cystic solid lesions; 3 were diagnosed as bronchogenic cysts with a diagnostic accuracy of 25% and 4 were misdiagnosed as pulmonary cystadenoma deformity. Conclusions Fetal bronchogenic cysts are easily associated with cystic adenomatoid deformity, pulmonary sequestration, and definite diagnosis of prenatal ultrasound. The value of prenatal ultrasound lies in the discovery and location of lesions, while assessing the mass of lung tissue, tracheal compression and mediastinal shift.