胎儿肝局灶性结节性增生的产前超声诊断与临床结局分析  

Prenatal diagnosis of focal nodular hyperplasia

作　　者：田瑞霞 魏卓君 顾莉莉[2] 崔智慧 陈锋 文华轩 李胜利 Tian Ruixia;Wei Zhuojun;Gu Lili;Cui Zhihui;Chen Feng;Wen Huaxuan;Li Shengli(Department of Obstetrics and Gynecology Ultrasound,the 901st Hospital of PLA,Hefei 230031,China;Department of Diagnostic Ultrasound,the Second Hospital of Anhui Medical University,Hefei 230601,China;Department of Ultrasound,Affiliated Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University,Shenzhen 518028,China)

机构地区：[1]联勤保障部队第九〇一医院妇产科,合肥230031 [2]安徽医科大学第二附属医院超声诊断科,合肥230601 [3]南方医科大学附属深圳妇幼保健院超声科,518028

出　　处：《中华医学超声杂志（电子版）》2020年第11期1070-1075,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨胎儿肝局灶性结节性增生(FNH)的产前超声声像图特征、诊断要点,分析其妊娠结局。方法回顾性分析2004年至2019年在联勤保障部队第九〇一医院、安徽医科大学第二附属医院、南方医科大学附属深圳妇幼保健院产前超声怀疑FNH 6例胎儿的基本资料,包括产前产后超声表现、实验室检查及妊娠转归,总结声像图特征及临床指导意见。结果6例胎儿产前超声均表现为肝内低回声肿块样病灶,形状规则,边界清晰,多呈椭圆形,未见明显包膜,彩色多普勒血流成像可见肝内血管在病灶内正常走行。6例胎儿均足月活产,其中1例于出生后14 d手术治疗,病理检查证实为FNH。余5例于出生后2个月内复查,肝内可见偏高回声病灶,边界清晰,内可见血管穿行。后期超声随访6例胎儿肝病灶逐渐缩小至消失,均未合并其他异常。结论肿块样病灶内肝血管穿行是产前超声诊断胎儿FNH的重要线索。Objective To assess the prenatal features of focal nodular hyperplasia and to analyze its pregnancy outcome.Methods The data of six cases of focal nodular hyperplasia,including prenatal ultrasonographic manifestations,laboratory examination,and pregnancy outcome,were retrospectively analyzed at the 901st Hospital of PLA,the Second Hospital of Anhui Medical University,and Affiliated Shenzhen Maternity&Child Healthcare Hospital,Southern Medical University from 2014 to 2019.The characteristics of sonograms and clinical guidelines were summarized.Results In all the six cases of fetal focal nodular hyperplasia,prenatal ultrasound showed a hepatic hypoechoic mass,with a regular shape(mostly oval),clear boundary,and no obvious capsule,and Color Doppler flow imaging showed normal intrahepatic blood vessels in the mass.All six cases had full-term live births,of whom one was operated on 14 days after birth and confirmed by pathology.One case was lost to follow-up,and the remaining five cases were reexamined at the age of 0.5 and 1 years,and the lesions gradually shrank to disappear.No other abnormalities were found in the six fetuses.Conclusion Intrahepatic vascular passage is an important clue for prenatal ultrasonography in diagnosing focal nodular hyperplasia of the fetal liver.

关 键 词：超声检查 产前 胎儿 局灶性结节性增生 肝 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]