Zhou Q C, Fan P, Peng Q H, Zhang M, Fu Z, Wang C H
Department of Ultrasonography, Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha, P.R. China.
Ultrasound Obstet Gynecol. 2004 Feb;23(2):165-71. doi: 10.1002/uog.979.
To present data on echocardiographic findings of fetal cardiac tumors and discuss their differential diagnoses.
We retrospectively reviewed 14 cases of fetal echogenic cardiac mass diagnosed between 1990 and 2003; 12 were confirmed to be cardiac tumors and two were false-positive diagnoses. The echocardiographic characteristics examined included number, size, location and associated complications.
Eight fetuses had a single tumor and four fetuses had multiple tumors. The left ventricle was most often affected. Parents of eight fetuses opted for termination of pregnancy, one fetus died in utero and three affected fetuses survived. Histopathological examination revealed cardiac rhabdomyoma in six fetuses, fibroma in two, teratoma in two, lipoma in one and hemangioma in one. The pitfalls associated with prenatal echocardiographic diagnosis of cardiac tumors include: they may be too small to be visualized, intracardiac echogenic foci may mimic tumors, and echogenicity resulting from extracardiac structures or neoplasms near the heart may falsely appear as tumors.
Fetal cardiac tumors can be detected by echocardiography. However, differential diagnosis is important as this will affect prognosis and subsequent management.
展示胎儿心脏肿瘤的超声心动图检查结果，并讨论其鉴别诊断。
我们回顾性分析了1990年至2003年间诊断出的14例胎儿心脏强回声团块病例；其中12例确诊为心脏肿瘤，2例为假阳性诊断。检查的超声心动图特征包括数量、大小、位置及相关并发症。
8例胎儿有单个肿瘤，4例胎儿有多个肿瘤。最常受累的是左心室。8例胎儿的父母选择终止妊娠，1例胎儿在子宫内死亡，3例患病胎儿存活。组织病理学检查显示，6例胎儿为心脏横纹肌瘤，2例为纤维瘤，2例为畸胎瘤，1例为脂肪瘤，1例为血管瘤。产前超声心动图诊断心脏肿瘤存在的问题包括：肿瘤可能太小无法显示，心内强回声灶可能类似肿瘤，心脏外结构或心脏附近肿瘤产生的回声可能被误视为肿瘤。
胎儿心脏肿瘤可通过超声心动图检测出来。然而，鉴别诊断很重要，因为这会影响预后及后续治疗。
