胎儿肾上腺区肿物的产前和产后超声诊断价值  

Diagnostic Value of Prenatal and Postnatal Ultrasonography for Fetal Adrenal Gland Masses

作　　者：张兴鹤 杨坡[1] 栗河舟[1] 黎全华[1] 贺盼盼[1] ZHANG Xinghe;YANG Po;LI Hezhou;LI Quanhua;HE Panpan(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《河南医学研究》2025年第8期1384-1387,共4页Henan Medical Research

摘　　要：目的 探讨胎儿肾上腺出血(AH)和肾上腺神经母细胞瘤(NB)的产前和产后超声图像特征以及临床诊断价值。方法 选择2019年1月至2023年4月在郑州大学第三附属医院进行超声检查初诊为肾上腺区肿物的胎儿44例,并采取动态追踪和出生后随访,比较分析胎儿AH和NB超声声像图特征的差异,并根据产后随访或病理结果评价临床诊断价值。结果 胎儿肾上腺区初次超声检查结果显示,34例胎儿39个肿物为AH,10例胎儿10个肿物为NB。产前AH和NB胎儿在初诊孕周、内部回声、回声变化以及内部血供方面差异有统计学意义(P<0.05);在病灶长径、肿物部位以及钙化情况等方面的差异无统计学意义(P>0.05)。产后随访或病理确诊结果显示,产前超声正确诊断肾上腺出血30例,误诊1例,终止妊娠3例,诊断准确率为96.77%(30/31);对肾上腺神经母细胞瘤诊断正确10例,诊断准确率为100%(10/10)。结论 AH和NB胎儿在初诊孕周、初诊超声声像图及内部血供等方面存在一定差别,结合动态随访观察内部回声及内部血供情况等变化情况,可更好地鉴别两种疾病,并且产前超声的临床诊断准确率较高。Objective To investigate the prenatal and postnatal ultrasonographic characteristics and clinical diagnostic value of fetal adrenal hemorrhage(AH)and adrenal neuroblastoma(NB).Methods A total of 44 fetuses primary diagnosed with adrenal area masses by ultrasound in the Third Affiliated Hospital of Zhengzhou University from January 2019 to April 2023 were selected for ultrasound examination.All fetuses were dynamically followed up and followed up after birth,and the differences of ultrasonographic features between fetal AH and NB were compared and analyzed.And the clinical diagnostic value of ultrasound in fetal adrenal area masses was assessed according to postpartum pathological results or postpartum follow-up.Results Primary ultrasound examination of fetal adrenal area was showed that 39 tumors in 34 fetuses were AH and 10 tumors in 10 fetuses were NB.There were significant differences between prenatal fetal AH and NB in gestational age,internal echo,echo variation,and internal blood supply(P<0.05).There was no statistical difference between AH and NB in lesion length,tumor site and calcification(P>0.05).The results of postpartum follow-up or pathological diagnosis showed that 30 cases of AH were correctly diagnosed by prenatal ultrasonography,1 case was misdiagnosed,and 3 cases terminated pregnancy,the diagnostic accuracy rate was 96.77%(30/31).Ten cases of NB were diagnosed correctly,and the diagnostic accuracy was 100%(10/10).Conclusion There are some differences between fetal AH and NB in terms of initial pregnancy week,initial ultrasound image and internal blood supply,etc.Combined with dynamic follow-up observation of internal echo and internal blood supply,the two diseases can be better distinguished,and the clinical diagnosis accuracy of prenatal ultrasound is higher.

关 键 词：肾上腺出血 肾上腺神经母细胞瘤 产前 产后 超声检查 内部回声和血供 

分 类 号：R714.5[医药卫生—妇产科学]