Prenatal diagnosis of ultrasound and MRI in the simple fetal indirect hernia

doi:10.3877/cma.j.issn.1672-6448.2015.11.013

Abstract

Abstract:

Objective

To explore the clinical value of ultrasound and MRI in diagnosis of simple fetal indirect hernia.

Methods

A total of 671 558 fetuses were examined in maternal and child healthcare hospital of Hubei from February 2003 to February 2015. Once inguinal hernia or testicular tumors was suspected, MRI examination was performed after prenatal ultrasound. Final diagnosis was confirmed by postnatal follow-up. The ultrasonographic characteristics of fetal indirect hernia were compared with prenatal MR image characteristics and postnatal follow-up results.

Results

Three cases were confirmed after birth. The simple fetal indirect hernia was uncommon clinical entity which occurred during 3rd trimester. The ultrasonic characteristics in prenatal period were: (1) Right enlarged scrotum was filled with heterogeneous lesion; intestinal peristalsis within the scrotum was found in real-time ultrasonography. (2) The contralateral testis in left scrotum and penis could be found. MRI could display the characteristics of indirect hernia contents and its extension from abdominal cavity into inguinal region, which may help diagnose fetal simple indirect hernia. One case of fetal indirect hernia was misdiagnosed as testicular tumors, which was correctly diagnosed by MRI.

Conclusions

The simple fetal indirect hernia can be prenatally diagnosed by characteristic ultrasonic features, which can present with abnormal mass in inguinal region. Prenatal ultrasound is the primary screening method of fetal indirect hernia. MRI can serve as a supplement approach. The combination of US and MRI can further improve the diagnostic accuracy of fetal indirect hernia.

Key words: Ultrasonography, prenatal, Magnetic resonance imaging, Fetal, Inguinoscrotal hernia

Qin Liu, Xiaohong Yang, Xinlin Chen, Xudong Yu, Wenzong Yang. Prenatal diagnosis of ultrasound and MRI in the simple fetal indirect hernia[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(11): 878-883.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2015.11.013

https://chaosheng.cma-cmc.com.cn/EN/Y2015/V12/I11/878

Figures/Tables 4

References 15

[1]	Ji EK, Yoon CS, Pretorius DH. Prenatal diagnosis of an inguinoscrotal hernia: sonographic and magnetic resonance imaging findings [J]. J Ultrasound Med, 2005, 24(2): 239-242.
[2]	Khatib N, Goldstein I, Vitner D, et al. Prenatal diagnosis of scrotal-inguinal hernia: two case reports and review of the English literature [J] . Eur J Obstet Gynecol Reprod Biol, 2013, 171(1): 9-11.
[3]	么海亮,于新凯, 孙建霞. 超声诊断胎儿左侧腹股沟斜疝1例 [J]. 中国医学影像学杂志, 2010, 26(10): 1983.
[4]	Skoog SJ, Conlin MJ. Pediatric hernias and hydroceles. The urologist′s perspective [J]. Urol Clin North Am, 1995, 22(1): 119-130.
[5]	Massaro G, Sglavo G, Cavallaro A, et al. Ultrasound prenatal diagnosis of inguinal scrotal hernia and contralateral hydrocele [J]. Case Rep Obstet Gynecol, 2013, 2013: 764579.
[6]	Bohlmann MK, Abele H, Gille C, et al. [Prenatal diagnosis of an inguino-scrotal hernia in a fetus with trisomy 18] [J]. Ultraschall Med, 2009, 30(5): 490-491.
[7]	Basaran A, Deren O, Onderoğlu LS. Prenatal diagnosis of Jarcho-Levin syndrome in combination with inguinoscrotal hernia [J]. Am J Perinatol, 2010, 27(3): 189-192.
[8]	Allen LM, Nosovitch JT Jr, Silverman RK, et al. Prenatal diagnosis of an inguinoscrotal hernia in a fetus with cystic fibrosis [J]. J Ultrasound Med, 2004, 23(10): 1391-1394.
[9]	Caserta L, Giorlandino M, Tiezzi A, et al. Atypical presentation of fetal inguino-scrotal hernia at 21 weeks of gestation: a case report [J]. J Prenat Med, 2007, 1(2): 35-36.
[10]	Kesby G, Beilby R, Petroni M. Fetal inguinoscrotal hernia: sonographic diagnosis and obstetric management [J]. Ultrasound Obstet Gynecol, 1997, 10(5): 359-361.
[11]	Frati A, Ducarme G, Vuillard E, et al. Prenatal evaluation of a scrotal mass using a high-frequency probe in the diagnosis of inguinoscrotal hernia [J]. Ultrasound Obstet Gynecol, 2008, 32(7): 949-950.
[12]	Siu SS, Leung TN, Leung TY, et al. Prenatal diagnosis of intra-abdominal mature testicular teratoma [J]. J Ultrasound Med, 2001, 20(11): 1257-1260.
[13]	Arena F, Nicòtina PA, Romeo C, et al. Prenatal testicular torsion: ultrasonographic features, management and histopathological findings [J]. Int J Urol, 2006, 13(2): 135-141.
[14]	Al-Salem AH. Intrauterine testicular torsion: a surgical emergency [J]. J Pediatr Surg, 2007, 42(11): 1887-1891.
[15]	杨小红, 陈欣林, 孙子燕, 等. 产前超声与MRI联合诊断泄殖腔外翻综合征一例及文献复习[J/CD]. 中华医学超声杂志:电子版, 2010, 7(10): 1757-1761.

例序	诊断孕周（周）	肿块大小（cm）	右侧阴囊肿块		右侧腹股沟区腹壁连续性	显示睾丸		显示阴茎	左侧阴囊积液
例序	诊断孕周（周）	肿块大小（cm）	蠕动	血流信号	右侧腹股沟区腹壁连续性	右侧	左侧	显示阴茎	左侧阴囊积液
1	33⁺⁴	3.6×3.1×3.2	＋	＋	-	-	＋	＋	＋^b
2	39	7.1×6.0×5.7	＋	-	-	-	＋	＋	＋^b
3	40	5.9×5.8×5.4	＋	＋^a	-	-	＋	＋	-

例序	诊断孕周（周）	肿块大小（cm）	右侧阴囊肿块		右侧腹股沟区腹壁连续性	显示睾丸		显示阴茎	左侧阴囊积液
例序	诊断孕周（周）	肿块大小（cm）	蠕动	血流信号	右侧腹股沟区腹壁连续性	右侧	左侧	显示阴茎	左侧阴囊积液
1	33⁺⁴	3.6×3.1×3.2	＋	＋	-	-	＋	＋	＋^b
2	39	7.1×6.0×5.7	＋	-	-	-	＋	＋	＋^b
3	40	5.9×5.8×5.4	＋	＋^a	-	-	＋	＋	-

例序	疝入阴囊的组织	右侧腹股沟区腹壁连续性	显示睾丸		左侧阴囊积液	显示阴茎	诊断结果
例序	疝入阴囊的组织	右侧腹股沟区腹壁连续性	右侧	左侧	左侧阴囊积液	显示阴茎	诊断结果
1	小肠及网膜，以网膜为主	＋	-	＋	＋^a	＋	先天性右侧腹股沟斜疝，左侧阴囊鞘膜积液
2	小肠	＋	-	显示不清	＋^a	显示不清	先天性右侧腹股沟斜疝，左侧阴囊鞘膜积液
3	小肠和网膜	＋	-	＋	-	＋	先天性右侧腹股沟斜疝

例序	疝入阴囊的组织	右侧腹股沟区腹壁连续性	显示睾丸		左侧阴囊积液	显示阴茎	诊断结果
例序	疝入阴囊的组织	右侧腹股沟区腹壁连续性	右侧	左侧	左侧阴囊积液	显示阴茎	诊断结果
1	小肠及网膜，以网膜为主	＋	-	＋	＋^a	＋	先天性右侧腹股沟斜疝，左侧阴囊鞘膜积液
2	小肠	＋	-	显示不清	＋^a	显示不清	先天性右侧腹股沟斜疝，左侧阴囊鞘膜积液
3	小肠和网膜	＋	-	＋	-	＋	先天性右侧腹股沟斜疝

检查方法	诊断例数	右侧腹壁连续中断	右侧疝内容物	左侧阴囊	阴茎
超声	2	未显示	均显示为肠管	可显示睾丸	可显示阴茎
MRI	3	显示清楚	均显示小肠，2例显示网膜	2例可显示睾丸，1例显示不清	2例可显示阴茎，1例显示不清

Please choose a citation manager

Content to export