摘要
目的探讨产前超声鉴别诊断胎儿颈部肿块的价值。方法回顾性分析50胎颈部肿块胎儿的影像资料及部分胎儿染色体结果,与产后新生儿特殊检查或病理结果相比较,总结其声像图特征、鉴别诊断要点与预后。结果 129 173胎胎儿(127 577例孕妇)产前超声共检出50胎颈部肿块。32胎经产后CDFI、MRI、CT或术后病理随访确诊,诊断淋巴管瘤20胎、血管瘤4胎、梨状窝囊肿8胎;18胎淋巴管瘤经引产后尸体解剖证实。超声对颈部肿块的诊断符合率为98.00%(49/50)。26胎淋巴管瘤超声表现为多房囊性,内见粗或细分隔带回声,肿块边界不清;12胎为单房囊性,囊壁薄,囊内透声好;CDFI示6胎肿块周边及分隔上星点状血流信号,32胎肿块无血流信号。颈部血管瘤超声表现为混合性或稍低实性,内部为厚壁囊性,呈蜂窝状,边界清晰;CDFI示肿块周边及内部丰富血流信号,其中1胎示动静脉瘘血流信号。6胎梨状窝囊肿超声显示为单房薄壁囊性,2胎合并感染囊壁增厚,囊内显示液平面;CDFI示6胎囊肿周边无血流信号,2胎囊肿周边星点状血流信号。结论产前超声可应用于胎儿颈部肿块的鉴别诊断。
Objective To explore the value of prenatal ultrasound in differential diagnosis of fetal neck mass.MethodsThe image data of 50 fetuses with neck mass and chromosomal results of part fetuses were retrospectively analyzed.Compared with postpartum neonatal special inspection results or/and pathological examination results,the sonographic features,key points of differential diagnosis and their prognosis were summarized.Results Totally 50 fetuses among 129 173fetuses（127 577 pregnant women）were detected with neck mass.Among them,32 fetuses were accurately diagnosed by CDFI,MRI,CT or pathological examination after delivery,including 20 fetuses of lymphangioma,4fetuses of hemangioma and 8fetuses of pyriform sinus cyst.And 18 fetuses of lymphangioma were confirmed through the corpse anatomical and pathological examination after induced labor.So the conformity rate of ultrasound in neck mass was 98.00%（49/50）.Twenty-six fetuses of lymphangioma showed multilocular with thick or subdivision strip and obscure boundary,and 12 fetuses were single cavity with thin wall and good sound.CDFI displayed star point blood flow signal on the surrounding and separating tissues of the masses in 6fetuses,and no blood flow signal in 32 fetuses.Hemangioma indicated mixed or slightly low signal,there was thick walled cystic like faveolate and clear bordline.CDFI displayed rich color blood flow signals inside and around mass,there was arteriovenous fistula blood flow signal in one fetus.Six fetuses pyriform sinus cyst showed single cavity and thin wall,and 2fetuses with thick wall and liquid plane.CDFI displayed star point blood flow signal in 2fetuses,and no blood flow signal in 6fetuses.Conclusion Prenatal ultrasound can be used for the differential diagnosis of fetal neck mass.
作者
李姣玲
耿秀平
曾红艳
张蕊
李小芬
LI Jiaoling GENG Xiuping ZENG Hongyan ZHANG Rui LI Xiao fen(Department of Ultrasound Department of Invasive Technology, Guangzhou Women＇ Children Medical Centre, Guangzhou 510623, China)
出处
《中国医学影像技术》
CSCD
北大核心
2017年第2期247-250,共4页
Chinese Journal of Medical Imaging Technology
关键词
超声检查
产前
胎儿
颈部肿块
Ultrasonography
prenatal
Fetus
Neck mass
