Prenatal diagnosis of fetal lung masses by ultrasonography and its clinical significance

doi:10.3877/cma.j.issn.1672-6448.2016.03.010

Abstract

Abstract:

Objective

To analyze the ultrasonographic features of fetal lung masses and their clinical prognosis.

Methods

There were total 38 fetuses with lung masses detected by prenatal ultrasonography in Suzhou Hospital Affiliated to Nanjing Medical University during June 1^st 2011 to May 31^st 2013. They were followed up to birth or induction of labor. Prenatal ultrasonographic features were analyzed by comparing to the CT examinations after birth or autopsy.

Results

Among 38 fetuses, there were 20 fetuses with cystic adenomatoid malformation (CAM) and 18 with pulmonary sequestration (PS) diagnosed by prenatal ultrasonography, and most of them were confirmed by CT after birth or autopsy. Their ultrasonogrphic characteristics and outcome were as followings. (1) Among 20 fetuses with CAM, there were 4 cases of CAM type Ⅰ, and their ultrasonography showed polycystic anechoic areas. Ultrasonography showed mixed echoic areas in 7 cases of type Ⅱ, and hyperechoic areas in 9 cases of type Ⅲ. After prenatal ultrasonography, 2 cases chose termination of pregnancy and were confirmed by autopsy. Lung masses in 6 cases disappeared gradually during follow up. Eleven cases were confirmed as CAM by CT after birth. However 1 case was missed follow-up. (2) Ultrasonography showed well-defined wedge-shaped hyper echo in 18 cases of PS, and color Doppler flow imaging (CDFI) showed that their blood supply were all from systemic circulation. Among 15 cases who underwent natural labor, masses in 9 cases disappeared during follow-up, and 6 cases were confirmed by CT after birth. The other 3 cases were missed.

Conclusions

Fetal lung masses have different ultrasonographic characteristics. Early and exact diagnosis has great significance for fetal prognosis and clinical management.

Key words: Ultrasonography, prenatal, Fetus, Lung mass, Cystic adenomatoid malformation of the lung, Pulmonary sequestration

Ping Wang, Xuedong Deng, Linliang Yin. Prenatal diagnosis of fetal lung masses by ultrasonography and its clinical significance[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(03): 213-217.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.03.010

https://chaosheng.cma-cmc.com.cn/EN/Y2016/V13/I03/213

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References 17

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肺部肿瘤	例数	二维超声表现	彩色多普勒超声表现
肺囊腺瘤	?	?	?
Ⅰ型	4	肿瘤内多个无回声区，最大无回声区47 mm×35 mm	无血供
Ⅱ型	7	肿瘤含多个无回声区的混合性回声，较大囊肿15 mm×13 mm	无血供
Ⅲ型	9	肿瘤呈增强回声，边界清晰	2例由肺动脉供血，7例无血供
隔离肺	18	肿瘤呈楔形稍高回声，大小不等，边界清晰，最大肿瘤大小为26 mm×26 mm×20 mm，较小肿瘤大小为10 mm×8 mm×9 mm	12例由胸主动脉供血、6例由腹主动脉供血

肺部肿瘤	例数	二维超声表现	彩色多普勒超声表现
肺囊腺瘤	?	?	?
Ⅰ型	4	肿瘤内多个无回声区，最大无回声区47 mm×35 mm	无血供
Ⅱ型	7	肿瘤含多个无回声区的混合性回声，较大囊肿15 mm×13 mm	无血供
Ⅲ型	9	肿瘤呈增强回声，边界清晰	2例由肺动脉供血，7例无血供
隔离肺	18	肿瘤呈楔形稍高回声，大小不等，边界清晰，最大肿瘤大小为26 mm×26 mm×20 mm，较小肿瘤大小为10 mm×8 mm×9 mm	12例由胸主动脉供血、6例由腹主动脉供血

肺部肿瘤	例数	合并畸形	临床预后
肺部肿瘤	例数	合并畸形	肿瘤消失	引产	新生儿肿瘤仍存在	失访
肺囊腺瘤	20	7	6	2	11	1
隔离肺	18	1	9	0	6	3

肺部肿瘤	例数	合并畸形	临床预后
肺部肿瘤	例数	合并畸形	肿瘤消失	引产	新生儿肿瘤仍存在	失访
肺囊腺瘤	20	7	6	2	11	1
隔离肺	18	1	9	0	6	3

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