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中华医学超声杂志(电子版) ›› 2015, Vol. 12 ›› Issue (10) : 812 -815. doi: 10.3877/cma.j.issn.1672-6448.2015.10.015

所属专题: 文献

妇产科超声影像学

脉络丛囊肿胎儿产前超声图像分析
张冬梅1, 侯莉1,(), 叶才为1   
  1. 1. 610031 四川省成都市妇女儿童中心医院
  • 收稿日期:2015-04-15 出版日期:2015-10-01
  • 通信作者: 侯莉

Analysis of prenatal ultrasound images in the fetal choroid plexus cyst

Dongmei Zhang1, Li Hou1,(), Caiwei Ye1   

  1. 1. Department of Ultrasound, Chengdu Women’s and Children’s Central Hospital, Chengdu 610031, China
  • Received:2015-04-15 Published:2015-10-01
  • Corresponding author: Li Hou
  • About author:
    Corresponding author: Hou Li, Email:
引用本文:

张冬梅, 侯莉, 叶才为. 脉络丛囊肿胎儿产前超声图像分析[J]. 中华医学超声杂志(电子版), 2015, 12(10): 812-815.

Dongmei Zhang, Li Hou, Caiwei Ye. Analysis of prenatal ultrasound images in the fetal choroid plexus cyst[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(10): 812-815.

目的

探讨脉络丛囊肿胎儿的产前超声声像图特征及产前超声诊断的临床意义。

方法

选取2011年1月至2013年7月在成都市妇女儿童中心医院产前超声检出的244例脉络丛囊肿病例随访至产后,对产前超声检查、染色体结果及临床结局进行回顾性分析。

结果

(1)单纯脉络丛囊肿232例。60例行染色体检查结果无异常,复查脉络丛囊肿231例27周前消失、1例产前与产后无明显大小变化,232例产后随访0.5~1.5年,婴幼儿发育未见异常。(2)合并轻微超声异常4例。肠管回声增强2例,膜状胎盘1例,胎盘绒毛增生1例,均无染色体异常,脉络丛囊肿均23周前消失,产后随访0.5~1.5年,婴幼儿发育未见异常。(3)合并严重或多发结构异常8例。共18个结构异常包括心脏畸形6例,脐膨出3例,脐带囊肿3例,手足内翻2例,唇裂、膈疝、小下颌、颈部水囊瘤各1例。1例21-三体,1例18-三体,5例无染色体异常,1例未做染色体检查。8例在孕中期引产。

结论

单纯或合并轻微超声异常的脉络丛囊肿多数孕27前可消失,胎儿预后良好。少数合并严重或多发的结构异常,染色体异常可能性增加,我们应行系统性或针对性产前超声检查及染色体核型分析。

Objective

To summarize the prenatal ultrasonographic features and the diagnostic value of fetal choroid plexus cyst (CPC).

Methods

From January 2011 to July 2013, 244 cases of fetuses with CPC diagnosed by prenatal ultrasound in our hospital were followed up till fetal birth. The ultrasonic, chromosomal and clinical results were analyzed retrospectively.

Results

(1) A total of 232 cases were simple CPC. Sixty cases were normal fetus in chromosomal examination. The cysts of 231 cases disappeared before the 27th gestational week while the cyst of 1 case remained the same size through entire observation period. A total of 232 babies had no abnormalities in the following 0.5 to 1.5 years after birth. (2) Four cases with slight ultrasonic abnormalities (without chromosomal abnormalities) included 2 cases of echogenic bowels, 1 case of membranacea placenta and 1 case of placental villus hyperplasia. All the cysts disappeared before the 23th gestational week and the babies developed well in the postnatal 0.5 to 1.5 years. (3) Eight cases with severe or multiple functional abnormalities had 18 structural defects, including 6 cases of cardiac defects, 3 cases of omphaloceles, 3 cases of umbilical cord cysts, 2 cases of limb varuses, 1 case of cleft lip, 1 case of diaphragmatic hernia, 1 case of micromandible and 1 case of hygroma colli. Among them, 2 cases had chromosome abnormalities (1 case of 21-trisomy syndrome and 1 case of 18-trisomy syndrome), 5 cases were normal and 1 case wasn't examined. These 8 fetuses were aborted.

Conclusion

The fetuses with CPC alone or slight ultrasonic abnormalties often have a good prognosis and most cysts may disappear during follow-up. However, the fetuses with severe or multiple functional abnormalities which may implicate higher risk of chromosome abnormalities have a poor prognosis and shall undergo systematic or targeted ultrasonography and clinical chromosomal examination.

图1~8 脉络丛囊肿及合并其他结构异常胎儿产前超声声像图。图1胎儿右侧脉络丛囊肿,直径约1.0 cm(箭头所示);图2胎儿双侧脉络丛囊肿,最大径约2.1 cm、2.0 cm(箭头所示);图3肠管回声增强,位于胎儿中下腹部;图4室间隔缺损,室间隔上段回声中断;图5胎盘绒毛增生,胎盘内蜂窝样改变;图6脐膨出,脐根部包块,周边脐血管包绕;图7脐带囊肿,彩色多普勒超声示囊肿内无血流信号;图8胎儿一侧手内翻
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