先天性囊性腺瘤样畸形体积比在胎儿肺隔离症预后产前评估中的应用。

Congenital Cystic Adenomatoid Malformation Volume Ratio in Prenatal Assessment of Prognosis of Fetal Pulmonary Sequestrations.

机构信息

Department of Medical Imaging, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang, 441000, China.

Medical Imaging Laboratory, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang, 441000, China.

出版信息

Curr Med Sci. 2019 Aug;39(4):658-662. doi: 10.1007/s11596-019-2088-1. Epub 2019 Jul 25.

DOI:10.1007/s11596-019-2088-1

PMID:31347005

Abstract

This study aimed to evaluate the prognosis of pulmonary sequestration (PS) by measuring congenital cystic adenomatoid malformation volume ratio (CVR) value in fetal congenital PS. The fetal CVR in 49 cases of fetal PS diagnosed by prenatal ultrasound in Xiangyang No. 1 People's Hospital from March 2010 to June 2017 were measured, and the clinical outcomes were observed. According to the prenatal ultrasound CVR value, 49 fetuses diagnosed with PS were divided into 2 groups: group 1 with CVR≥1.26, and group 2 with CVR<1.26. The incidence rate of fetal edema, respiratory distress symptoms and survival rate were compared between the two groups. The risk factors of the fetal PS were evaluated by single and multiple Logistic regression analysis. The correlation between CVR and fetal prognosis was analyzed. Of the 49 fetuses, there were 34 cases of PS (ILS) type (69.39%, 34/49), 10 cases of PS (ELS) type I (20.41%, 10/49) and 5 cases of PS (ELS) type II (10.20%, 5/49). Forty-six cases (93.88%, 46/49) were born alive, there was 1 case (CVR ≥1.26) (2.04%, 1/49) of induced abortion, and 2 cases (CVR ≥1.26) (4.08%, 2/49) of stillbirths. In group 1 (n=24), 21 cases were born alive, and the incidence rate of newborn respiratory distress and fetal edema was 100% (21/21) and 79.17% (19/24) respectively. In group 2 (n=25), there were 3 cases (12%,3/25) of newborn respiratory distress, 3 cases (12%, 3/25) of fetal edema, and the rate of live birth was 100%. There were statistically significant differences between the two groups in the incidence of fetal edema, postpartum respiratory symptoms and survival rate. CVR was a risk factor for PS and was associated with fetal prognosis. CVR in the midtrimester of pregnancy is an effective index to evaluate the prognosis of fetal PS. CVR ≥1.26 is associated with an increased risk of fetal edema, infant respiratory distress and intrauterine or postnatal death.

摘要

这项研究旨在通过测量产前超声诊断的胎儿肺隔离症（PS）中的先天性囊状腺肌瘤体积比（CVR）值来评估 PS 的预后。测量了 2010 年 3 月至 2017 年 6 月在襄阳市第一人民医院通过产前超声诊断的 49 例胎儿 PS 的胎儿 CVR，并观察了临床结果。根据产前超声 CVR 值，将 49 例诊断为 PS 的胎儿分为 2 组：CVR≥1.26 的组 1 和 CVR<1.26 的组 2。比较两组胎儿水肿、呼吸窘迫症状发生率和存活率。通过单因素和多因素 Logistic 回归分析评估胎儿 PS 的危险因素。分析 CVR 与胎儿预后的相关性。在 49 例胎儿中，PS（ILS）型 34 例（69.39%，34/49），PS（ELS）型 I 10 例（20.41%，10/49），PS（ELS）型 II 5 例（10.20%，5/49）。46 例（93.88%，46/49）存活分娩，1 例（CVR≥1.26）（2.04%，1/49）引产，2 例（CVR≥1.26）（4.08%，2/49）死产。在组 1（n=24）中，21 例存活分娩，新生儿呼吸窘迫和胎儿水肿的发生率分别为 100%（21/21）和 79.17%（19/24）。在组 2（n=25）中，新生儿呼吸窘迫 3 例（12%，3/25），胎儿水肿 3 例（12%，3/25），活产率为 100%。两组在胎儿水肿、产后呼吸症状和存活率方面均有统计学差异。CVR 是 PS 的危险因素，与胎儿预后相关。妊娠中期 CVR 是评估胎儿 PS 预后的有效指标。CVR≥1.26 与胎儿水肿、婴儿呼吸窘迫和宫内或产后死亡的风险增加相关。