Zalel Yaron, Weisz Boaz, Gamzu Ronni, Schiff Eyal, Shalmon Bruria, Achiron Reuven
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.
J Ultrasound Med. 2002 Aug;21(8):909-13. doi: 10.7863/jum.2002.21.8.909.
To evaluate our experience with sonography and color Doppler blood flow in the diagnosis and management of chorioangiomas of the placenta.
All cases with placental chorioangiomas diagnosed in our sonography unit between 1992 and 2001 were included in the study. Sonographic and color Doppler flow characteristics were evaluated in all cases. Our cases were compared with all cases of placental chorioangiomas diagnosed antenatally by sonography published in the English literature between 1978 and 2001.
Six cases of placental chorioangioma were identified antenatally, with a mean size of 6.5 cm (range, 4-13 cm). With the use of color Doppler flow, all cases of chorioangioma were shown to have either abundant blood flow or a large feeding vessel within the tumor. During follow-up, 2 cases had reduction of the intratumoral blood flow, and the outcomes were favorable. Three of our cases had delivery before 33 weeks' gestation (1 with intrauterine fetal death and 1 with termination of pregnancy). Review of the literature revealed 72 cases of antenatally diagnosed placental chorioangioma. Two thirds of the cases had dismal outcomes.
The sonographic diagnosis of chorioangiomas of the placenta is feasible and necessitates close surveillance of these pregnancies because of the dismal prognosis in more than half. The addition of color Doppler flow is important in the diagnosis and antenatal follow-up of these pregnancies.
评估超声检查及彩色多普勒血流成像在胎盘绒毛膜血管瘤诊断及处理中的应用经验。
纳入1992年至2001年间在我院超声科诊断为胎盘绒毛膜血管瘤的所有病例。对所有病例的超声及彩色多普勒血流特征进行评估。将我们的病例与1978年至2001年间英文文献中发表的所有经产前超声诊断的胎盘绒毛膜血管瘤病例进行比较。
产前确诊6例胎盘绒毛膜血管瘤,平均大小为6.5 cm(范围4 - 13 cm)。使用彩色多普勒血流成像显示,所有绒毛膜血管瘤病例在瘤体内均有丰富血流或粗大供血血管。随访期间,2例瘤体内血流减少,结局良好。我们的病例中有3例在妊娠33周前分娩(1例宫内胎儿死亡,1例终止妊娠)。文献回顾显示有72例产前诊断的胎盘绒毛膜血管瘤病例。其中三分之二的病例结局不佳。
胎盘绒毛膜血管瘤的超声诊断可行,鉴于半数以上病例预后不佳,对这些妊娠需密切监测。彩色多普勒血流成像在这些妊娠的诊断及产前随访中具有重要作用。