产前超声在胎儿骶尾部畸胎瘤成熟性鉴别中的价值  

Value of prenatal ultrasound in differential diagnosis of mature and immature fetal sacrococcygeal teratoma

作　　者：张娟[1] 吴青青[1] 王莉[1] 张铁娟[1] 韩吉晶[1] Zhang Juan;Wu Qingqing;Wang Li;Zhang Tiejuan;Han Jijing(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院北京妇幼保健院超声科,100026

出　　处：《中华医学超声杂志（电子版）》2022年第8期796-800,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨不同病理类型胎儿骶尾部畸胎瘤(SCT)的临床及产前超声声像图特征,分析产前超声在胎儿SCT成熟性鉴别中的作用。方法回顾性分析2015年1月至2020年12月在首都医科大学附属北京妇产医院就诊的胎儿SCT病例34例,根据肿瘤不同病理类型将病例分为成熟型和未成熟型,分析不同病理类型组的母体年龄、孕周及肿瘤相关超声特征(生长方式、性质、血流情况)、合并症,并采用χ2检验、Fisher确切概率检验、t检验及Mann-Whitney U检验比较上述资料的组间差异。结果根据肿瘤的病理类型分为成熟型组23例和未成熟型组11例。在2组病例中,母体年龄、孕周、胎儿性别、肿瘤生长方式的组间差异均无统计学意义(P均>0.05)。未成熟型组肿瘤体积明显大于成熟型组[16.19(8.47,34.03)cm3 vs 186.20(90.41,445.35)cm3],差异具有统计学意义(Z=-3.332,P=0.001);成熟型组肿瘤以囊性为主(56.5%,13/23),未成熟型组肿瘤均为囊实性(100%,11/11),差异具有统计学意义(P=0.002)。彩色多普勒超声显示成熟型组伴血流信号者有3例,未成熟组则有10例,差异具有统计学意义(P<0.001)。对肿瘤周围组织以及胎儿其他器官系统扫查发现,成熟型组出现合并症者5例,未成熟型组为7例,组间差异具有统计学意义(P=0.026)。结论不同病理类型胎儿SCT的临床特征及产前超声表现不同,产前超声表现为囊实性肿瘤、体积较大、血流信号丰富、合并其他系统异常等是未成熟型SCT的重要鉴别征象,早期诊断可为后续产科管理提供诊疗依据。Objective To evaluate the clinical and ultrasonic features of fetal sacrococcygeal teratoma(SCT)of different histological types.Methods A retrospective analysis was performed on a total of 34 patients with SCT that was diagnosed from January 2015 to December 2016 at Beijing Obstetrics and Gynecology Hospital,Capital Medical University.These cases were divided into either a mature group or an immature group based on the histological type.Data(maternal age,gestational weeks,and tumorous sonographic features)were analyzed by the Fisher exact test,t-test,Chi-square,and Mann-Whitney U test.Results No statistical differences were observed in terms of maternal age,gestational week,fetal sex,and Altman's classification between the mature(n=23)and immature groups(n=11).Among all the ultrasonic features,mass volume of the immature group was significantly bigger than that of the mature group[16.19(8.47,34.03)cm3 vs 186.20(90.41,445.35)cm3,Z=-3.332,P=0.001].The main manifestation of the mature group was cystic echo(56.5%,13/23),while that of the immature group was cystic-solid echo(100%,11/11);the difference between the two groups was statistically significant(P=0.002).Color Doppler ultrasound showed that three cases in the mature group and ten cases in the immature group were detected with blood flow signal;the difference in the number of cases with blood flow signal was statistically significant between the two groups(P<0.001).Scanning of the tissues surrounding the mass and other fetal systems showed that five cases in the mature group and seven cases in the immature group suffered from complications;there was a statistically significant difference between the two groups(P=0.026).Conclusion The clinical features and prenatal ultrasonic images of fetal SCT vary with different pathological types.Cystic-solid echogenic masses,bigger mass volume,rich blood flow signals,and suffering from complications are important signs for the diagnosis of immature fetal SCT.Early diagnosis by using prenatal ultrasound can provide a good ba

关 键 词：骶尾部畸胎瘤 胎儿 产前超声 成熟型 未成熟型 

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]