Maternity Department, Necker-Enfants Malades Hospital, 75015 Paris, France.
J Ultrasound Med. 2010 Apr;29(4):633-8. doi: 10.7863/jum.2010.29.4.633.
The purpose of this series was to report the contribution of 3-dimensional ultrasonographic (3DUS) technologies in performing the prenatal diagnosis of main stem bronchial atresia (BA).
We report 2 cases in which the prenatal diagnosis of main stem BA was performed using 3DUS technologies. Both fetuses presented with extremely enlarged hyperechoic right lungs, shifting the mediastinum to the left, associated with hydrops and polyhydramnios. A revision of the literature was made, focusing on the prenatal characteristics and perinatal prognosis of main stem BA.
In the first case, a congenital type III cystic adenomatoid malformation was suspected initially, but a posterior 3DUS analysis on multiplanar imaging allowed identification of a dilated right bronchus, and a right main stem BA was confirmed at autopsy. In the second case, volume contrast imaging was used during fetal scanning, which also allowed identification of the right main bronchial dilatation. In reviewing the literature, we found a tendency for main stem BA to be more severe than lobar and segmental atresias.
Three-dimensional ultrasonographic technologies may improve the pre-natal diagnosis of main stem BA.
本系列旨在报告三维超声（3DUS）技术在主支气管闭锁（BA）产前诊断中的作用。
我们报告了 2 例使用 3DUS 技术进行主支气管 BA 产前诊断的病例。这两个胎儿的右肺均极度增大呈高回声，纵隔向左移位，伴发水肿和羊水过多。我们对文献进行了复习，重点关注主支气管 BA 的产前特征和围产期预后。
在第一个病例中，最初怀疑为先天性 III 型囊性腺瘤样畸形，但在后位 3DUS 多平面成像分析中可识别出扩张的右支气管，并在尸检中证实为右主支气管闭锁。在第二个病例中，在胎儿扫描期间使用了容积对比成像，也可识别出右主支气管扩张。在文献复习中，我们发现主支气管 BA 比肺叶和节段性闭锁更为严重。
三维超声技术可能提高主支气管 BA 的产前诊断。
