胎儿肝血管瘤的超声特征及预后  

The Analysis of Ultrasonographic Features and Prognosis of Fetal Congenital Hepatic Hemangioma

作　　者：李云桃[1] 闫亚妮[1] 杨振娟[1] 薛小伟 张超[1] 王雁[1] 刘国莉[1] 裴秋艳[1] Li Yuntao;Yan Yani;Yang Zhenjuan;Xue Xiaowei;Zhang Chao;Wang Yan;Liu Guoli;Pei Qiuyan(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院妇产科,北京市100044

出　　处：《中国超声医学杂志》2023年第4期468-471,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的对先天性肝血管瘤的产前、产后超声特征及预后进行分析,提高先天性肝血管瘤的产前诊断率,为产前咨询提供依据。方法对产前诊断12例胎儿肝血管瘤病例的超声特征及预后进行分析。结果二维超声显示12例病例均为单发病灶,所有病灶和周围肝脏分界清,7例为囊实性,5例为实性回声。彩色及频谱多普勒显示12例病灶周围均可见明显的环状血流信号,病灶内部见丰富或不丰富血流信号,内探及动静脉瘘样频谱;其滋养血管来源于肝动脉并经肝静脉回流,肝动脉及受累肝静脉明显扩张,血流速度增快。随访显示1例在出生前病灶消退,1例生后无消退,余10例在出生后病灶完全或部分消退。结论胎儿肝血管瘤超声表现的多样性和复杂性构成其产前超声的特征性改变。大多数胎儿肝血管瘤出生后可以自愈,少数需要药物或手术治疗,预后良好。Objective To improve prenatal diagnosis rate and provide evidence for prenatal counselling by summarizing the ultrasonographic features of fetal congenital hepatic hemangioma before and after birth.Methods The ultrasonographic features and prognosis of 12 cases of fetal hepatic hemangioma in our hospital were analyzed.Results The two dimension ultrasonography showed that all the 12 cases in our hospital were single lesion with clear boundary between all lesion and peripheral hepatic parenchyma,7 cases had cystic-solid heterogeneous echo and 5 cases had solid hypoechoic.The color doppler and spectrum showed that obvious annular blood flow around the lesions in 12 cases,plentiful or poor blood flow was seen inside the lesions,and the spectrum of arteriovenous fistula could be detected in the area with plentiful blood flow.The feeding vessels originated from the hepatic artery and returned through the hepatic vein,the hepatic artery and the affected hepatic vein dilated significantly,and the velocity of the hepatic artery increased.The follow-up showed the lesion in l case had involuted before birth,the lesion in the l case had non-involuted after birth,the remaining 1o cases had completely or partial involuted after birth.Conclusions The variety and complexity of ultrasound manifestations in fetal hepatic hemangioma constitute the characteristic changes of prenatal ultrasound.Most fetal hepatic hemangiomas can heal themselves after birth,and a few require drug or surgical treatment and have a good prognosis.

关 键 词：胎儿 肝血管瘤 超声特征 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]