Westerburg B, Feldstein V A, Sandberg P L, Lopoo J B, Harrison M R, Albanese C T
Department of Surgery, University of California, San Francisco 94143-0570, USA.
J Pediatr Surg. 2000 Feb;35(2):322-5; discussion 325-6. doi: 10.1016/s0022-3468(00)90032-0.
A subset of fetuses with sacrococcygeal teratoma (SCT) develops hydrops caused by high-output heart failure. Identification of fetuses at risk for hydrops is important because fetal intervention may reverse the pathophysiology of the disease. To date, no reliable sonographic prognostic factors have been identified.
An experienced sonologist reviewed the sonographic records of 17 fetuses with SCT referred to the authors' institution. Size of the tumor was measured and corrected for fetal size. The appearance of the tumor (solid versus cystic) and its vascularity were graded on a subjective scale of 1 to 5.
Only 4 of 12 fetuses that had hydrops survived; of the survivors, 3 had undergone fetal intervention. All nonhydropic fetuses survived. Fetuses with hydrops had tumors that were mainly solid and highly vascular, whereas nonhydropic fetuses had predominantly cystic tumors with comparatively less vascularity. There was no significant difference in tumor size between these 2 groups.
Fetuses with SCT that are mainly solid in appearance and are highly vascularized have a higher risk of getting hydrops in utero. Tumor size is not an independent prognostic factor.
一部分患有骶尾部畸胎瘤（SCT）的胎儿会因高输出量心力衰竭而发生水肿。识别有水肿风险的胎儿很重要，因为胎儿干预可能会逆转该疾病的病理生理过程。迄今为止，尚未发现可靠的超声预后因素。
一位经验丰富的超声科医生回顾了转诊至作者所在机构的17例患有SCT胎儿的超声检查记录。测量肿瘤大小并根据胎儿大小进行校正。肿瘤的外观（实性与囊性）及其血管分布按1至5的主观量表进行分级。
12例发生水肿的胎儿中只有4例存活；在存活者中，3例接受了胎儿干预。所有未发生水肿的胎儿均存活。发生水肿的胎儿的肿瘤主要为实性且血管丰富，而未发生水肿的胎儿的肿瘤主要为囊性，血管分布相对较少。这两组之间的肿瘤大小无显著差异。
外观主要为实性且血管丰富的SCT胎儿在子宫内发生水肿的风险较高。肿瘤大小不是一个独立的预后因素。
