先天性肝血管瘤的产前超声诊断与漏误诊分析  

Prenatal ultrasound diagnosis and analysis of missed diagnosis and misdiagnosis of congenital hepatic hemangioma

作　　者：郭爽萍 尚宁[1] 安思微 Guo Shuangping;Shang Ning;An Siwei(Department of Ultrasound Diagnosis,Guangdong Women and Children’s Hospital,Guangzhou 511400,Guangdong,China)

机构地区：[1]广东省妇幼保健院超声诊断科,广东广州511400

出　　处：《中国产前诊断杂志（电子版）》2021年第2期51-54,共4页Chinese Journal of Prenatal Diagnosis(Electronic Version)

摘　　要：目的探讨先天性肝血管瘤的产前超声特征及漏误诊原因。方法回顾性分析2014年1月1日至2018年12月31日在广东省妇幼保健院产前诊断的先天性肝血管瘤共35例,随访至出生后1年以上,分析其超声图像特征及漏误诊原因。结果35例胎儿中有31例证实为肝血管瘤,多为晚孕期检出,23例位于肝右叶,14例边界清晰,14例为不均质回声,20例可探及丰富血流信号,血流呈高速中阻型,16例为环状或半环状血流,13例见肝动脉来源供血及肝动脉内径稍增宽。中孕期漏诊1例,误诊3例(2例为肝母细胞瘤,1例为肺隔离症)。结论产前超声对先天性肝血管瘤有重要的诊断价值,但与肝母细胞瘤鉴别较困难,中孕期应注意对肝脏的扫查,避免漏诊。Objective To investigate the prenatal ultrasound characteristics and causes for missed diagnosis and misdiagnosis of congenital hepatic hemangioma.Methods A total of 35 fetuses with congenital hepatic hemangioma prenatally diagnosed in Guangdong Women and Children Hospital from January 1,2014 to December 31,2018 were retrospectively analyzed.The fetuses were followed up till more than one year after birth,and their ultrasonic image characteristics and the causes of missed diagnosis and misdiagnosis were analyzed.Results Among the 35 fetuses,31 were confirmed with congenital hepatic hemangioma,most of which were detected in the late pregnancy.Among them,23 fetuses suffered from hemangioma in the right lobe of the liver,14 presented clear boundaries,14 showed heterogeneous echoes,20 had abundant detectable blood flow signals indicating high-speed flow and moderate vascular resistance,16 exhibited circular or semicircular blood flows,and 13 were detected with blood supply from hepatic artery and slight widening in the internal diameter of hepatic artery.During mid-pregnancy,missed diagnosis occurred in 1 fetus,and misdiagnosis in 3 fetuses(2 fetuses with hepatoblastoma and 1 with pulmonary sequestration).Conclusions Prenatal ultrasound is of great value in the diagnosis of congenital hepatic hemangioma.However,congenital hepatic hemangioma is difficult to be differentiated from hepatoblastoma.During mid-pregnancy,attention should be paid to the scanning of the liver to avoid missed diagnosis.

关 键 词：先天性血管瘤 先天性肝血管瘤 超声 产前诊断 

分 类 号：R714.53[医药卫生—妇产科学] R445.1[医药卫生—临床医学]