产前超声测量肺头比评估胎儿先天性肺囊腺瘤样畸形预后的研究  

Prenatal Ultrasound Measurement of Cystic Volume Ratio for Prognosis Evaluation in Congenital Cystic Adenomatoid Malformation

作　　者：张海春[1] 田军章[2] 陈钟萍[3] 周苏晋[1] 祁丹[4] 邓雪红[4] 

机构地区：[1]广东省第二人民医院超声科,广东广州510010 [2]广东省第二人民医院院长室,广东广州510010 [3]广东省人民医院超声科,广东广州510010 [4]广东省妇幼保健院超声诊断科,广东广州510010

出　　处：《中国医学影像学杂志》2016年第5期367-370,共4页Chinese Journal of Medical Imaging

基　　金：广东省医学科研基金资助课题(B2014026);广东省现代医院管理研究所科研基金资助课题(201404);中国医师协会超声医师分会中国超声医师科技新星计划(201604)

摘　　要：目的胎儿先天性肺囊腺瘤样畸形(CCAM)的早期明确诊断及产前评估对产前咨询及临床处理具有重要意义,本文通过产前超声测量CCAM胎儿肺头比(CVR),探讨CVR在CCAM胎儿预后评估中的应用价值。资料与方法回顾性分析产前超声诊断为CCAM的84例胎儿的影像与临床资料,测量胎儿CVR,分为CVR<1.6组及CVR≥1.6组,比较两组胎儿水肿发生率、产后呼吸系统症状发生率及围生儿存活率。结果 84例胎儿中,产前超声诊断为CCAM I型12例(14.3%),CCAM II型48例(57.1%),CCAM III型24例(28.6%);78例(92.9%)活产,4例(4.8%)引产,2例(2.4%)死胎;CVR<1.6组68例,2例(2.9%)胎儿水肿,3例(4.4%)产后出现呼吸困难等呼吸系统症状;CVR≥1.6组16例,12例(75.0%)胎儿水肿,9例(81.8%)产后出现呼吸系统症状。两组胎儿水肿发生率、产后呼吸系统症状发生率及围生儿存活率比较,差异有统计学意义(P<0.001)。结论 CVR≥1.6的CCAM胎儿宫内水肿发生率及产后呼吸系统症状发生率均增高,CVR是评价CCAM胎儿预后的有效指标。Purpose Early diagnosis of congenital cystic adenomatoid malformation（CCAM） and prenatal assessment are important for prenatal counseling and clinical management. The Purpose of this paper is to evaluate the prognostic efficacy of cystic volume ratio（CVR） in diagnosing fetal CCAM. Materials and Methods Eighty-four cases of prenatally diagnosed CCAM fetuses using ultrasound by measuring CVR were retrospectively analyzed, and further divided into CVR1.6 group and CVR ≥ 1.6 group, the fetal hydrops rate, incidence of respiratory symptoms after birth and perinatal infant survival rate of two groups were compared. Results In 84 cases, prenatal ultrasound diagnosed CCAM type I in 12 cases（14.3%）, CCAM type II in 48 cases（57.1%）, and CCAM type III in 24 cases（28.6%）. There were 78（92.9%） live births, 4 cases（4.8%） of induction, 2 cases（2.4%） of intrauterine fetal death. In 68 cases of CVR1.6, 2 cases（2.9%） had combined fetal hydrops and 3 cases（4.4%） had respiratory symptoms after birth. In 16 cases of CVR≥1.6, 12 cases（75.0%） had combined fetal hydrops and 9 cases（81.8%） had respiratory symptoms after birth. The fetal hydrops rate, incidence of respiratory symptoms after birth and perinatal infant survival rate were statistically different（P0.001）. Conclusion When CVR ≥1.6, fetal hydrops and postnatal respiratory symptom rate increase. CVR is an effective indicator in prenatal evaluation of CCAM.

关 键 词：囊腺瘤样畸形 肺 先天性 超声检查 产前 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学]