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目的探讨产前超声在评估胎儿先天性肺囊性腺瘤样畸形(CCAM)预后中的临床价值。方法回顾性分析35例产前超声诊断为CCAM的超声声像图特征,并测量CCAM胎儿病变部位的体积与头围的比值—肺头比(CVR),并与临床结果相比较。结果 35例CCAM中Ⅰ型1例,Ⅱ型16例,Ⅲ型18例,一例为双侧病变,其余均位于一侧胸腔。26例胎儿CVR<1.6,3例合并心脏移位,其余无合并症,5例肿块产前逐渐缩小(包括1例有心脏移位的),1例产后出现轻度呼吸系统症状,余新生儿一般情况良好;9例胎儿CVR≥1.6,除1例双侧病变,其余8例均合并心脏移位,3例出现胎儿水肿,2例出现羊水过多;5例孕妇选择终止妊娠,余均足月生产,产后均出现呼吸系统症状,两例经手术治疗,其余未做进一步治疗,预后均良好。结论产前超声动态观察并结合CVR值是评估CCAM胎儿预后的有效方法。
Objective To investigate the clinical value of prenatal ultrasound in assessing the prognosis of fetal congenital cystic adenomatoid malformation (CCAM). Methods We retrospectively analyzed the features of 35 cases with CCAM diagnosed by prenatal ultrasound and measured the volume to head circumference ratio (CFR) of the fetal lesion in CCAM and compared with the clinical results. Results Among 35 cases of CCAM, type Ⅰ was found in 1 case, type Ⅱ in 16 cases and type Ⅲ in 18 cases. One case was bilateral and the others in one side of the chest. 26 cases of fetal CVR <1.6, 3 cases of cardiac displacement, the rest without complications, 5 cases of prenatal gradually reduced (including 1 case of cardiac displacement), 1 postpartum mild respiratory symptoms, more than newborn 9 cases of fetal CVR≥1.6, except for 1 case of bilateral lesions, the remaining 8 cases were complicated with cardiac displacement, 3 cases of fetal edema, 2 cases of polyhydramnios; In 5 cases of pregnant women choose to terminate the pregnancy, and I have enough Respiratory symptoms occurred in both months and postpartum. Two cases were treated surgically and the rest were not treated further. The prognosis was good. Conclusions Prenatal ultrasound dynamic observation combined with CVR value is an effective method to evaluate the prognosis of CCAM.