总结胎儿期中胚层肾瘤的超声表现并与病理组织学类型对照分析。

对 2003 年 1 月至 2018 年 12 月湖北省妇幼保健院产前超声发现肾区肿块并经病理证实的 4例中胚层肾瘤胎儿的超声图像、磁共振影像特征、病理组织学类型及随访结果进行综合分析。

4例中胚层肾瘤超声特征：4例胎儿中胚层肾瘤均于晚孕期被检出，发现肿块时径线均较大（直径均＞ 6 cm），均为单侧肾区单发肿块，实性或囊实性；肿块与周围组织分界清，其中 3 例可于肿块一极见少许残肾回声，彩色多普勒超声显示肿块内部均可见较丰富的“树枝状”血流信号，均合并羊水多。产前胎儿磁共振影像均显示肿块内部有不同程度坏死灶，肿块边界清楚，周边可见受压的残肾组织。随访结果：3 例孕妇选择终止妊娠，1 例出生后行患侧肾切除手术，预后良好。超声与病理类型对照：1 例超声显示为完全实性肿块，病理组织学类型为经典型；而囊实性肿块及实性为主肿块 3 例，病理组织学类型为细胞型或混合型。

中胚层肾瘤是胎儿期常见的肾肿瘤，有特征性的超声表现，影像学特征与病理组织学类型有一定相关性，超声与磁共振联合诊断有助于正确诊断而减少误诊。

To summarize the ultrasonographic findings of fetal mesoblastic nephroma and compare them with pathological findings.

The ultrasonographic images, magnetic resonance images, pathological types, and follow-up results of four cases of fetal mesoblastic nephroma discovered by prenatal ultrasound at Maternal and Child Health Hospital of Hubei Province from January 2003 to December 2018 were analyzed retrospectively.

All the four cases of mesoblastic nephroma were detected in late pregnancy. The diameter of all the masses was larger than 6 cm. All masses were single, unilateral, and solid or cystic solid. The boundary between the mass and surrounding tissue was clear. A little residual kidney echo could be seen in three cases. Abundant dendritic blood flow signals could be detected inside the masses by color Doppler ultrasonography, and all of them were complicated with amniotic fluid. The prenatal fetal MRI imaging features showed different necrotic ranges inside the mass, the boundary of the mass was clear, and the pressed residual renal tissue was visible around it. Three pregnant women terminated pregnancy, and one case underwent ipsilateral nephrectomy after birth, with a good prognosis. In one case showing a complete solid mass, the pathological tissue type was classical, while a cystic-solid mass or mass with predominant solid components was found in three cases, in which the tissue type was cellular or mixed type.

Mesoblastic nephroma is a common fetal renal tumor with characteristic ultrasonographic features, and there is a certain correlation between imaging features and pathological types. The combined diagnosis of ultrasound and magnetic resonance imaging is helpful to diagnose correctly and reduce misdiagnosis.