| 摘要: |
| 目的 探讨先天性肺囊腺瘤样畸形(CCAM)的产前超声声像图特点,并分析其与预后的关系。方法 对产前超声诊断CCAM的46例胎儿进行回顾性分析,分析其产前超声声像图特点、胸廓指标、有无合并纵隔移位、羊水过多、胎儿水肿或积液、其他畸形、随访体积变化及预后。结果 (1)CCAM的产前超声声像图特点：根据其囊肿大小分为大囊型(I型,9/46)、中囊型(II型,22/46)和微囊型(III型,15/46)。病变位于单侧43例,双侧3例。CCAM不同分型的CCAM体积头围比(CVR)、肺体积和胸廓体积比逐渐增大(P＜0.05),而肿块体积、胸廓横径、前后径、面积、胸围、肺体积以及胸廓体积之间无明显差异(P＞0.05)。(2)CCAM合并症：不同分型在有无羊水过多、有无胎儿水肿或积液之间对比,III型最多,I型最少(P＜0.05),而在有无纵隔移位、有无合并其他畸形、随访体积变小上差异无统计学意义(P＞0.05)；(3)CCAM预后：不同分型在妊娠结局上,III型预后最差(P＜0.05),而在产后干预上差异无统计学意义,合并胎儿水肿预后差。结论 (1)CCAM具有典型的产前超声声像图特点,其分型与囊肿大小、CVR、肺体积和胸廓体积比有关；(2)不同类型CCAM合并症不一样,产前超声可根据分型及合并症判断预后,III型预后较I型、II型差。 |
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| DOI： |
| 投稿时间：2019-04-10修订日期：2020-03-29 |
| 基金项目:福建省卫生计生青年科研课题(2018-1-62)、泉州市科技计划项目(2018N012S)、福建省泉州医学高等专科学校母婴健康服务应用技术协同创新中心基金赞助(XJM1802)作者单位：362000 福建医科大学附属第二医院通讯作者：吕国荣,Email:lxh_3dus@sina.com 叶冯颖 吕国荣 |
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| the Effect of Prenatal Ultrasonography in Diagnosis and Prognosis of Congenital Cyst Adenomatous Lung MalformationLIAN Xihua, YE Fengying, LYU Guorong |
| lianxihua |
| (the Second Affiliated Hospital of Fujian Medical University) |
| Abstract: |
| ABSTRACT Objective To investigate the prenatal ultrasonography characteristics and prognosis of congenital cystic adenomatoid malformation (CCAM). Methods Forty-six fetuses of prenatally diagnosed CCAM using ultrasonography were retrospectively analyzed. The prenatal ultrasonographic features, thoracic indicators, presence or absence of mediastinal shifts, polyhydramnios, fetal edema or hydrops, complicated malformation , mass volume changes and prognosis at follow-up were analyzed. Results (1)Prenatal ultrasonography characteristics of CCAM: According to the size of cyst, the CCAM can be divided into large cystic type (type I, 9/46), medium cystic type (type II, 22/46) and micro cystic type (type III, 15/46). The lesions were located in unilateral thorax in 43 cases and bilateral thorax in 3 cases. The CCAM volume ratio (CVR), lung volume and thoracic volume ratio were gradually increased in different CCAM types (P<0.05), while there was no significant difference in mass volume, thoracic transverse diameter, anteroposterior diameter, area, chest circumference, lung volume and thoracic volume in different CCAM types (P > 0.05). (2) Complications of CCAM: The presence or absence of polyhydramnios, fetal edema, hydrops was different among different types, type III was more than type II, and type I was the least (P< 0.05), while there was no statistically significant difference in mediastinal shift, complicated malformation, and decreased mass size at follow-up (P > 0.05). (3) Prognosis of CCAM: The pregnancy outcomes were different in different types, type III was the worst (P＜0.05), while there was no statistically significant difference in postpartum intervention. The prognosis of fetuses complicating with hydrops were poor.
Conclusion (1) Prenatal ultrasonography characteristics of CCAM is typical . The classification of CCAM is related to the size of cyst, CVR, lung volume and thoracic volume ratio. (2) The complications are different in different types of CCAM , prenatal ultrasound can evaluate the prognosis according to the types and complications, type III is worse than type I and type II. |
| Key words: Prenatal Ultrasonography Congenital Cyst Adenomatous Lung Malformation Diagnosis, Prognosis |
