胎儿卵巢囊肿的产前超声诊断与处理
Antenatal ultrasonographic diagnosis and management of fetal ovarian cysts.
作者信息
Giorlandino C, Bilancioni E, Bagolan P, Muzii L, Rivosecchi M, Nahom A
机构信息
Artemisia Medical Center, Rome, Italy.
出版信息
Int J Gynaecol Obstet. 1994 Jan;44(1):27-31. doi: 10.1016/0020-7292(94)90019-1.
OBJECTIVES
The aim of the present study was to evaluate the outcome of fetal ovarian cysts in relation to their ultrasonic appearance and size.
METHODS
Forty-two fetal ovarian cysts were diagnosed in 41 fetuses and followed with serial ultrasonograms in utero and after birth until spontaneous or surgical resolution.
RESULTS
Twelve fetal ovarian cysts that were echogenic at diagnosis and six that were anechoic at diagnosis but became echogenic at subsequent prenatal sonograms were all submitted to postnatal surgery. Of the remaining 24 cysts, all anechoic, four were successfully aspirated in utero, 11 resolved spontaneously after birth, and nine underwent postnatal surgery for complication. The outcome of cysts that were anechoic at diagnosis was significantly correlated with size (P = 0.01).
CONCLUSIONS
Echogenic fetal ovarian cysts should be always surgically removed. The outcome of anechoic cysts depends on the size at diagnosis, and serial ultrasonographic assessment is recommended; although not randomized, the present series suggests that in utero aspiration of cysts > 5 cm may prevent complication and subsequent oophorectomy.
目的
本研究旨在评估胎儿卵巢囊肿的超声表现及大小与其预后的关系。
方法
41例胎儿被诊断出42个胎儿卵巢囊肿，在子宫内及出生后进行系列超声检查，直至囊肿自行消退或手术切除。
结果
诊断时为强回声的12个胎儿卵巢囊肿，以及诊断时为无回声但在随后产前超声检查中变为强回声的6个囊肿，均接受了产后手术。其余24个囊肿均为无回声，其中4个在子宫内成功穿刺抽吸，11个在出生后自行消退，9个因并发症接受了产后手术。诊断时为无回声的囊肿的预后与大小显著相关（P = 0.01）。
结论
强回声胎儿卵巢囊肿应始终进行手术切除。无回声囊肿的预后取决于诊断时的大小，建议进行系列超声评估；尽管本研究未进行随机分组，但本系列研究表明，对直径> 5 cm的囊肿进行子宫内穿刺抽吸可能预防并发症及随后的卵巢切除术。
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