【摘要】：目的探討產(chǎn)前超聲鑒別診斷胎兒頸部腫塊的價值。方法回顧性分析50胎頸部腫塊胎兒的影像資料及部分胎兒染色體結(jié)果,與產(chǎn)后新生兒特殊檢查或病理結(jié)果相比較,總結(jié)其聲像圖特征、鑒別診斷要點(diǎn)與預(yù)后。結(jié)果 129 173胎胎兒(127 577例孕婦)產(chǎn)前超聲共檢出50胎頸部腫塊。32胎經(jīng)產(chǎn)后CDFI、MRI、CT或術(shù)后病理隨訪確診,診斷淋巴管瘤20胎、血管瘤4胎、梨狀窩囊腫8胎;18胎淋巴管瘤經(jīng)引產(chǎn)后尸體解剖證實(shí)。超聲對頸部腫塊的診斷符合率為98.00%(49/50)。26胎淋巴管瘤超聲表現(xiàn)為多房囊性,內(nèi)見粗或細(xì)分隔帶回聲,腫塊邊界不清;12胎為單房囊性,囊壁薄,囊內(nèi)透聲好;CDFI示6胎腫塊周邊及分隔上星點(diǎn)狀血流信號,32胎腫塊無血流信號。頸部血管瘤超聲表現(xiàn)為混合性或稍低實(shí)性,內(nèi)部為厚壁囊性,呈蜂窩狀,邊界清晰;CDFI示腫塊周邊及內(nèi)部豐富血流信號,其中1胎示動靜脈瘺血流信號。6胎梨狀窩囊腫超聲顯示為單房薄壁囊性,2胎合并感染囊壁增厚,囊內(nèi)顯示液平面;CDFI示6胎囊腫周邊無血流信號,2胎囊腫周邊星點(diǎn)狀血流信號。結(jié)論產(chǎn)前超聲可應(yīng)用于胎兒頸部腫塊的鑒別診斷。
[Abstract]:Objective to evaluate the value of prenatal ultrasound in differential diagnosis of fetal neck masses. Methods the imaging data of 50 fetuses with cervical mass and the results of some fetal chromosomes were analyzed retrospectively. Compared with the special examination or pathological results of postpartum newborns, the sonographic features, differential diagnosis and prognosis were summarized. Results 50 cases of cervical mass were detected by prenatal ultrasound in 129,173 fetuses (127,577 pregnant women), 32 cases were diagnosed by postpartum CDFI,MRI,CT or pathological follow-up, 20 cases were diagnosed with lymphangioma, 4 cases with hemangioma, 8 cases with piriform fossa cyst. 18 fetal lymphangiomas were confirmed by autopsy after induced labor. The diagnostic accuracy of ultrasonography for cervical mass was 98.00% (49 / 50). CDFI showed stellate blood flow signal on the periphery and septum of the tumor in 6 cases and no blood flow signal in 32 cases. The cervical hemangioma showed mixed or slightly lower solid, thick-walled cystic inside, honeycomb shape and clear boundary. CDFI showed abundant blood flow signal around and inside the tumor, of which 1 fetus showed blood flow signal of arteriovenous fistula. 6 cases of piriform fossa cyst were demonstrated as one-locular-thin-wall cystic, 2 cases were complicated with infection cystic wall thickening, and the fluid level was displayed in the capsule. CDFI showed that there was no blood flow signal around 6 fetal cysts, and starspot blood flow signal around 2 fetal cysts. Conclusion Prenatal ultrasound can be used in the differential diagnosis of fetal neck masses.
【作者單位】： 廣州市婦女兒童醫(yī)療中心超聲科;廣州市婦女兒童醫(yī)療中心介入科;
【分類號】：R445.1;R714.5

【參考文獻(xiàn)】

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1 韓瑾;劉鴻圣;潘敏;甄理;楊昕;曾斯慧;李東至;虞翌e，

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