产前超声诊断胎儿腹部囊性占位效果及误诊原因分析  

Value of prenatal ultrasound for diagnosing fetal abdominal cystic masses and analysis of the causes of the misdiagnose

作　　者：柏禹竹 汤蓓[1] 蒋琴[1] BAI Yuzhu;TANG Bei;JIANG Qin(Sichuan Maternal and Child Health Care Hospital,Chengdu,Sichuan Province,610041)

机构地区：[1]四川省妇幼保健院,成都610041

出　　处：《中国计划生育学杂志》2021年第5期1066-1068,F0003,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨产前超声在胎儿腹部囊性占位中的诊断价值。方法:以2017年12月—2019年12月本院收治的产前超声发现胎儿腹部囊性占位孕妇59例临床资料,比较产前超声检查与产后或引产后解剖结果,分析产前超声在胎儿腹部囊性占位中的诊断效果。结果:产前超声诊断59例存在胎儿腹部囊性占位中,产后或引产后解剖证实有55例确诊占位,产前超声诊断误诊率为5.1%(4/59),准确率为94.9%(55/59);59例胎儿腹部囊性占位囊性肿块分别来源于肝脏、胆道、生殖系统、消化道以及泌尿系统,误诊4例中胆道来源囊性肿块1例实际为胆道闭锁,消化道来源囊性肿块误诊2例实际为先天性巨结肠1例、环状胰腺1例,泌尿系统来源囊性肿块误诊1例实际为肠系膜囊肿;59例胎儿腹部囊性占位囊性肿块发生部位位于上腹部15例,其中胆总管囊肿5例,位于腹膜后31例,其中肾积水22例,位于下腹部13例,其中卵巢囊肿9例。结论:产前超声能够有效发现胎儿腹部囊性占位,但有一定误诊,提示临床医生在分析产前超声影像资料时,尤其需要关注易出现误诊现象的囊性包块来源,降低误诊率。Objective: To study the diagnostic value of prenatal ultrasound for fetal abdominal cystic masses. Methods: 59 pregnant women with fetal abdominal cystic masses found by prenatal ultrasound between December 2017 and December 2019 were included as objects of this study. The results of prenatal ultrasound examination and the results of postpartum examination or anatomy of fetus after induction of labor were compared. The diagnostic value of prenatal ultrasound for fetal abdominal cystic masses was analyzed. Results: Among 59 pregnant women with fetal abdominal cystic masses diagnosed by prenatal ultrasound, 55 women with fetal abdominal cystic masses were confirmed by postpartum examination or fetal anatomy after induction of labor. The misdiagnosis rate and accuracy rate of prenatal ultrasound for fetal abdominal cystic masses were 5.1%(4/59) and 94.9%(55/59). The abdominal cystic masses of 55 fetuses were derived from the liver, biliary tract, reproductive system, digestive tract, and urinary system. Among 4 misdiagnosis cases, 1 case of misdiagnosed cystic mass derived from biliary tract by prenatal ultrasound actually was biliary atresia, and 2 cases of misdiagnosed cystic mass derived from digestive tract by prenatal ultrasound were actually congenital megacolon, 1 case misdiagnosed cystic mass derived from digestive tract by prenatal ultrasound actually was actually annular pancreas, and 1 case of misdiagnosed cystic mass derived from urinary system by prenatal ultrasound was actually mesenteric cyst. In 55 cases of fetal abdominal cystic masses, 15 cases occurred in the upper abdomen and 5 cases was choledochocyst, 31 cases occurred in retroperitoneum and 22 cases was hydronephrosis, 13 cases occurred in lower abdomen and 9 cases were ovarian cyst. Conclusion: Prenatal ultrasound can effectively detect the fetal abdominal cystic masses with certain misdiagnose rate. It is suggested that clinicians should pay more attention to the source of the fetal abdominal cystic masses which may lead to misdiagnosis when

关 键 词：胎儿腹部囊性占位 彩色多普勒超声 诊断效果 误诊原因 

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]