产前超声诊断胎儿肺囊性病

摘要

目的 探讨超声诊断胎儿肺囊性病,主要是先天性肺囊腺瘤(CCAM)及隔离肺(PS)的临床应用价值.方法 对常规产前筛查怀疑先天性肺囊性病的23胎行进一步超声检查,重点观察胎儿肺内病变的回声特征、血供情况,并定期进行超声复查,观察有无纵隔偏移、羊水量增多或腹腔积液等合并症及其他结构异常,随访妊娠结局.结果 23胎于产前诊断为先天性肺囊性病,其中20胎为CCAM(20/23,86.96％),2胎为PS(2/23,8.70％),1胎为CCAM合并PS(1/23,4.35％).7胎(7/23,30.43％)发生纵隔移位,3胎(3/23,13.04％)出现羊水过多,另有1胎出现腹腔积液(1/23,4.35％).随访结果表明,9胎(9/23,39.13％)活产,其中5胎病变在产前出现自发性减小甚至消退；其余14胎引产(14/23,60.87％).结论 产前超声对于诊断胎儿肺囊性病有重要临床价值.%Objective To explore the clinical value of prenatal ultrasonography in diagnosis of fetal cystic lung diseases, especially congenital cystic adenomatoid malformation (CCAM) and pulmonary sequestration (PS). Methods Totally 23 fetuses with suspected cystic lung disease underwent ultrasound examination. Serial ultrasonography was performed to monitor the development of the lesions and to assess the presence or absence of complications such as mediastinal shift, poly-hydramnios, hydrops and other associated abnormalities. Then the outcome was evaluated during follow-up. Results Twenty-three fetuses were diagnosed as congenital cystic lung diseases prenatally, including 20 CCAM (20/23, 86. 96%) , 2 PS (2/23, 8. 70%) and 1 CCAM combined with PS (1/23, 4. 35%). Mediastinal shift was found in 7 fetuses (7/23, 30. 43%), polyhydramnios in 3 (3/23, 13. 04%) and seroperitoneum in 1 (1/23, 4. 35%). The follow-up outcome indicated that 9 fetuses were born alive (9/23, 39. 13%), in 5 of which the lesions' volume reduced or even disappeared spontaneously before birth. And the pregnancy was terminated in other 14 fetuses (14/23, 60. 87%). Conclusion Prenatal ultrasonography is of great clinical value in diagnosis of fetal cystic lung diseases.