Zeng Wen-Hua, Wang Xian-Jin, Zhou Xin
Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, People's Republic of China.
Int J Womens Health. 2022 Jun 30;14:837-843. doi: 10.2147/IJWH.S357938. eCollection 2022.
This study aimed to investigate the value of prenatal ultrasonography in the differential diagnosis of fetal space-occupying lesions in the adrenal gland.
Thirty-six fetuses with adrenal gland space-occupying lesions diagnosed by prenatal ultrasonography between January 2019 and July 2021 were included in this retrospective study. The clinical data, ultrasonographic features, treatments, and prognoses of the fetuses were analyzed. Postnatal diagnoses were made using computed tomography (CT), magnetic resonance imaging, and surgical resection.
Of the 36 fetuses, 10 were diagnosed with adrenal hematomas, eight with adrenal neuroblastomas, seven with adrenal cysts, seven with subphrenic pulmonary sequestration, and four with adrenal teratomas. The accuracy of prenatal diagnosis was highest in those with adrenal cysts and subphrenic pulmonary sequestration, with the accuracy being 85.7% for both conditions. The mean gestational age at first detection of subphrenic pulmonary sequestration was 22.5 ± 3.1 weeks, which was significantly lower than that of other diagnoses ( < 0.05), and the mean diameter of adrenal cysts was 15.1 ± 4.2 mm, which was significantly smaller than that of other lesions ( < 0.05). All newborns with adrenal teratomas and neuroblastomas were treated surgically. Five of the seven patients with subphrenic pulmonary sequestration and three of the seven patients with cysts were also treated surgically. Follow-ups of the remaining cases were carried out by enhanced CT examination, and the prognoses were good.
Prenatal ultrasonography can help differentiate between different types of fetal adrenal space-occupying lesions, and there is a high coincidence rate between the diagnosis of adrenal cysts and subphrenic pulmonary sequestration.
本研究旨在探讨产前超声检查在胎儿肾上腺占位性病变鉴别诊断中的价值。
本回顾性研究纳入了2019年1月至2021年7月间经产前超声检查诊断为肾上腺占位性病变的36例胎儿。分析了这些胎儿的临床资料、超声特征、治疗情况及预后。产后诊断采用计算机断层扫描（CT）、磁共振成像及手术切除。
36例胎儿中，10例诊断为肾上腺血肿，8例为肾上腺神经母细胞瘤，7例为肾上腺囊肿，7例为膈下肺隔离症，4例为肾上腺畸胎瘤。产前诊断肾上腺囊肿和膈下肺隔离症的准确率最高，两种情况的准确率均为85.7%。首次发现膈下肺隔离症时的平均孕周为22.5±3.1周，显著低于其他诊断（<0.05），肾上腺囊肿的平均直径为15.1±4.2mm，显著小于其他病变（<0.05）。所有肾上腺畸胎瘤和神经母细胞瘤新生儿均接受了手术治疗。7例膈下肺隔离症患者中的5例和7例囊肿患者中的3例也接受了手术治疗。其余病例通过增强CT检查进行随访，预后良好。
产前超声检查有助于鉴别不同类型的胎儿肾上腺占位性病变，肾上腺囊肿和膈下肺隔离症的诊断符合率较高。
