胎儿颈部囊性淋巴瘤的超声诊断  

Prenatal sonographic diagnosis of nuchal Cystic hygromas

作　　者：李映桃[1] 陈小兵[1] 梁伟翔[2] 刘笑霞[1] 

机构地区：[1]广州医学院第三附属医院广州市重症孕产妇救治中心妇产科,510150 [2]广州医学院第三附属医院广州市重症孕产妇救治中心超声科,510150

出　　处：《临床超声医学杂志》2007年第10期591-593,共3页Journal of Clinical Ultrasound in Medicine

基　　金：广州市卫生局科研课题(2005-YB-165)

摘　　要：目的探讨超声在诊断胎儿颈部囊性淋巴瘤(NCH)的作用。方法回顾性分析我院18例NCH超声诊断的特点,超声介入性穿刺检查胎儿染色体或基因情况及胎儿病理。结果NCH超声诊断率为72.2%,颈部透明层厚度(NT)筛查阳性率为1.6%。产前NCH超声图像特点:NT厚度为2.5～4.0mm,颈周及肩背部见囊性无回声区最小为0.85cm×0.58cm×0.5cm,最大为12.6cm×6.6cm×4.0cm,包膜完整。并发胸腔积液7例,胸腹腔积液及皮下积液5例,双手外翻畸形1例。8例活胎超声介入性穿刺检查胎儿染色体,6例异常。胎儿病理:18例为胎儿颈部囊状淋巴瘤,7例合并多发畸形。17例治疗性引产,另1例剖宫产分娩活女婴。结论NCH典型的超声图像可筛查和诊断NCH,并在超声介导下检查胎儿染色体或基因情况,评估胎儿预后,指导临床处置。NCH与Turner综合征和三体型相关,常伴发多种畸形。Objective To investigate the effect of ultrasonography in prenatal diagnosis of nuchal cystic hygromas（NCH）. Methods Eighteen cases of fetal nuchal cystic hygroma from Mar, 1996 to Dee,2006 were analysised retrospectively. The sonographic images, fetal karyotype examination after amniocentesis or chorionic villus sample （CVS） and pathology were reviewed. Results The rates of the prenatal sonographic diagnosis of NCH were 72.2%. The positive rates of the screen NT were 1.6%. The thickness of NT was 2.5 - 4.0 mm, and five cases more than 3 mm. The sonogram detected a anechoic cystic mass around the posterior of the neck. The smallest one was 0.85 cm × 0.58 cm × 0.5cm and the biggest was 12.6 cm × 6.6 cm × 4.0 cm. the nuehal ligament could be seen in- side the cystic mass. Seven cases complicated with pleura effusions and 5 with pleural effusions, ascites and skin edema. One case was deliveried in full tenn. The other 17 cases were induced （including 6 fetal death）. The karyotype examination was performed in 8 case and six of them were abnormal. Fetal pathology result Shoued that： 18 eases were NCH, but 7 cases had other abnormalities （twins were thymic dysplasia, four were polycystic kidney disease, the other was skeletal abnormalities）. Conclusion Ultrasotmd and invasive amniocentesis can diagnose and evaluate nuchal cystic hygroma. Nuchal cystic hygromas are associated with Turner syndrome and other chromosomal abnormalities.

关 键 词：超声检查 囊性淋巴瘤 产前诊断 预后 

分 类 号：R739.91[医药卫生—肿瘤]