胎儿Galen静脉动脉瘤样畸形超声表现及误漏诊原因分析  

Ultrasound Manifestation and Causes of Misdiagnosis and Missed Diagnosis of Fetal Vein of Galen Aneurysmal Malformation

作　　者：杨苹 卢小霞 YANG Ping;LU Xiao-xia(Department of Ultrasound,the Sixth Hospital of Wuhan City the Affiliated Hospital of Jianghan University,Wuhan 430015,China)

机构地区：[1]江汉大学附属医院,武汉市第六医院超声医学科,武汉430015

出　　处：《临床误诊误治》2021年第11期5-8,16,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨胎儿Galen静脉动脉瘤样畸形(VGAM)超声表现及误漏诊原因。方法对2011年3月—2020年10月收治的产前诊断胎儿VGAM 23例的临床资料进行回顾性分析。结果本组胎儿均为单活胎,孕妇于孕28周后自觉胎动次数明显减少,行胎心监护发现心率异常。超声确诊胎儿VGAM 20例,误诊为蛛网膜囊肿2例,漏诊1例。后误漏诊3例均经MRI检查及超声复查确诊胎儿VGAM。16例因病灶较大,均在超声确诊后行引产术;7例病灶较小,均妊娠至足月患儿娩出,娩出后6例先后死亡,1例经介入治疗后情况良好。结论VGAM具有特征性超声表现,预后与病灶大小及心血管情况、是否合并其他严重畸形密切相关。胎儿VGAM产前超声系统筛查极为重要,能给予临床诊断和治疗明确指导。Objective To explore ultrasound manifestations and causes of misdiagnosis and missed diagnosis of fetal vein of Galen aneurysmal malformation(VGAM).Methods Clinical data of 23 patients with prenatal diagnosis of fetal VGAM admitted between March 2011 and October 2020 was retrospectively analyzed.Results The fetuses in this group were single live fetuses.After gestation for 28 weeks,the number of maternal awareness of fetal movements was significantly reduced,and then abnormal heart rates were found under fetal heart monitoring.Among them,20 cases of fetal VGAM were diagnosed by ultrasound examinations,2 cases were misdiagnosed as arachnoid cysts,and 1 case was missed diagnosis.The 3 cases of misdiagnosis and missed diagnosis were all diagnosed as fetal VGAM by magnetic resonance imaging(MRI)and ultrasound re-diagnosis.Among them,16 patients underwent induction of labor after confirmation by ultrasound due to large lesions;7 patients had smaller lesions,and they had full-term delivery,but 6 fetuses died successively after delivery,and 1 fetus was in good condition after interventional treatment.Conclusion Ultrasonographic images of VGAM have characteristic manifestations,and the prognosis is closely related to the lesion size,the cardiovascular status of the fetus and presence or absence of combination with other serious malformations.The prenatal ultrasound system screening of fetal VGAM is vital,which may provide clear guidance for clinical diagnosis and treatment.

关 键 词：GALEN静脉动脉瘤样畸形 超声检查 误诊 蛛网膜囊肿 漏诊 

分 类 号：R714.431[医药卫生—妇产科学]