胎儿肺内病灶的产前超声诊断及其结局分析  

Prenatal ultrasonographic diagnosis and outcome of congenital lung abnormal lesion

作　　者：陈琮瑛[1] 李胜利[1] 欧阳淑媛[2] 刘菊玲[1] 文华轩[1] 毕静茹[1] 姚远[1] 杨晓东[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院超声科,深圳518028 [2]南方医科大学附属深圳市妇幼保健院遗传室,深圳518028

出　　处：《中华超声影像学杂志》2008年第7期612-614,共3页Chinese Journal of Ultrasonography

基　　金：广东省医学科研基金项目（20030706）

摘　　要：目的探讨胎儿肺内病灶的声像特征及其临床价值和结局分析。方法常规二维超声扫查评估胎儿双侧肺，发现异常声像时，再用彩色多普勒显示病灶内部血流供应情况并注意观察有无胎儿水肿和其他结构异常声像。在首次超声发现异常后，无胎儿水肿声像表现者，每隔4～6周后复查。结果40例首次超声发现的肺内异常病灶中表现为强回声者21例，囊实性混合回声者15例，囊性者4例。8例产前超声提示为隔离肺，12例超声提示为肺囊腺瘤，其余20例未予以具体病理诊断提示。17例追踪复查显示病灶稳定或缩小或消失，新生儿结局良好；17例合并胎儿水肿或包块最大直径〉5．0cm及纵隔移位，患者及家属要求终止妊娠。结论产前彩色多普勒超声可发现胎儿肺内病灶，鉴别其病理性质及监测其发展变化，胎儿单纯肺内异常病灶、无胎儿水肿和纵隔移位且病灶稳定或缩小者结局良好，常规产前超声对发现胎儿肺内病灶和评估其预后有重要价值。Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image（CDFI） when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses, 15 cases with cystic-solid mixture masses, 4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration （PS） were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

关 键 词：超声检查 产前 肺疾病 支气管肺隔离症 囊腺瘤样畸形 肺 先天性 

分 类 号：R686[医药卫生—骨科学]