先天性肺囊性腺瘤样畸形的CT表现

目的 探讨小儿先天性肺囊性腺瘤样畸形的影像学表现,提高对该病的认识.方法 11例小儿先天性肺囊性腺瘤样畸形均经手术、病理证实,术前胸部CT平扫,7例病变区加做高分辨率CT扫描.结果 双肺受累3例,右肺受累5例,左肺受累3例,CT表现单个或多个含气囊腔(直径>2 cm)6例,多发蜂窝样囊腔(直径<1 cm)5例,囊内含气9例,2例囊内含少量液体,7例伴有不同程度肺气肿.5例合并纵隔疝,1例合并先天性肺隔离症.所有病变有一定的占位效应.结论 先天性肺囊性腺瘤样畸形的CT表现有一定特征可为该病诊断提供可靠信息.     

先天性肺囊性腺瘤样畸形的CT表现

目的:探讨先天性肺囊性腺瘤样畸形的CT表现。方法:回顾性分析15例先天性肺囊性腺瘤样畸形的CT表现,并与手术、病理结果对照。结果:15例先天性肺囊性腺瘤样畸形CT表现为大囊型10例、小囊型5例。病理检查见囊腔为异常增生的管腔或腺样结构,壁内被覆假复层纤毛柱状上皮8例,纤毛柱状及立方上皮7例;囊周可见平滑肌及弹性纤维环绕,15例囊壁内均未见软骨成分及腺体。结论:CT检查是诊断先天性肺囊性腺瘤样畸形的可靠方法,根据CT表现可推测其病理分型。     

胎儿先天性肺囊腺瘤样畸形的MRI诊断与鉴别诊断

目的:探讨MRI在胎儿先天性肺囊腺瘤样畸形(CCAM)诊断与鉴别诊断中的应用价值.方法:36例孕妇,年龄21～38岁,平均29岁;孕龄20～31周,平均24周.产前常规行超声(US)检查后24～48h内行MR检查,采用二维快速平衡稳态采集 (2D-FIESTA) 序列、单次激发快速自旋回波(SSFSE)序列,行胎儿颅脑...     

小儿先天性肺囊性腺瘤样畸形的影像学表现

目的：描述小儿先天性肺囊性腺瘤样畸形的影像学表现，以提高对该病的认识。方法：男7例，女1例，平均年龄3岁10个月。均以反复呼吸道感染就诊，病史4d至8年。8例均经手术，病理证实，术前摄胸片及胸部CT平扫，3例病变区加人高分辨率CT扫描。结果（1）胸片见单个或多个毗邻含气大囊（囊径＞3cm)4例，多发蜂窝样小囊（囊径＜3cm)的3例，1例表现为肺纹理模糊，6例合并纵隔肺疝，患侧肺气肿样改变8例，（2）CT见左右肺受累各4例，2例表现为巨大囊腔（囊腔最大径约9cm)，2例呈类圆形薄壁囊腔（囊径3.8-5.6cm)，4例表现为多发蜂窝样小囊（囊径0．2－3.2cm)，囊内以含气为主，3例囊内含水量液体，病变均有不同程度的占位效应。（3）病理检查见囊腔为异常增生的管腔或腺样结构，壁内被覆假复层纤毛柱状上皮3例，纤毛柱状及立方上皮5例；囊周可见平滑肌及弹性纤维环绕，8例囊壁内均未见软骨成分及腺全。结论：影像学检查为诊断先天性肺囊性腺瘤样畸形的可靠方法，它可以提出定位，定性诊断，CT能明显提高病变的检出率。     

Sudden neonatal death from congenital cystic adenomatoid malformation

We report a case of congenital cystic adenomatoid malformation (CCAM) of the lungs resulting in sudden death immediately after birth. The case is extremely unusual because of the diffuse bilateral involvement. The extensive involvement of both lungs could explain the abrupt onset of the symptoms and the ineffectiveness of resuscitation attempts. The presence of cartilage as a part of the malformation adds interest to the case, since it is seldom found in this malformation and to the best of ¶our knowledge has been reported only exceptionally in a ¶type II CCAM.     

成人肺先天性囊性腺瘤样畸形

目的 探讨成人肺先天性囊性腺瘤样畸形（CCAM）的影像学表现，提高影像诊断水平。方法 对5例经手术病理证实的CCAM的影像学资料进行随访和回顾性分析，5例均有X线胸片，其中2例行胸部CT扫描。结果 5例中3例胸部X线表现为肺内薄壁低密度透亮区，部分囊内有液平面。1例为下肺近胸膜处蜂窝状、网格状、囊状空腔，周围可见毛刺征，1例为相邻数个类圆形空腔。胸部CT见1例右肺中叶外侧段椭圆形透亮区，壁薄且光整，左肺上叶尖后段薄壁囊状透亮区，且与胸膜相连。1例双下肺基底段近胸膜处蜂窝状薄壁空腔，右下叶基底段肿块影，可见毛刺征。结论 CCAM的影像学表现为胸膜下的囊性或囊实性病变，同时有伴发肺癌的危险性。     

胎儿先天性肺囊性腺瘤样畸形的MRI诊断

目的:探讨MRI对胎儿先天性肺囊性腺瘤样畸形(CCAM)的诊断价值。方法:分析34例经产后病理证实的CCAM的MRI表现。结果:34例MRI扫描示,病灶位于左侧12例,右侧22例。出生后经胸部CT增强扫描比较,1例未发现病灶,2例误诊为先天性肺隔离症,1例误诊为先天性肺气肿。结论:MRI能很好显示胎儿CCAM的位置和形态,对该病的诊断具有较高价值。     

Antenatal ultrasound diagnosis of cystic adenomatoid malformation of the lung

Cystic adenomatoid malformation is a rare congenital pulmonary anomaly. We report an antenatal diagnosis by ultrasonography and discuss the differential diagnosis.     

Congenital cystic adenomatoid malformation

Congenital cystic adenomatoid malformation of the lung is a rare lesion that typically manifests as neonatal respiratory distress secondary to progressive expansion of the affected lung. Three distinct types have been described based on the size of the cysts and the microscopic appearance. Type I lesions are characterized by large cysts of varying sizes (measuring more than 2 cm in diameter), type II lesions typically contain cysts of a more uniform size (not exceeding 2 cm in diameter), and type III lesions contain microscopic cysts. Radiologic findings include single or multiple large cysts, multiple small cysts of uniform size, and solid-appearing masses. The treatment of choice is excision of the affected lobe. The prognosis is favorable in the absence of pulmonary hypoplasia, fetal hydrops, or associated congenital anomalies.     

超声诊断胎儿肺囊腺瘤样畸形1例

孕妇26岁。G1P0,停经29周+1,胎动好,无先天畸形家族史。超声所见:胎儿生长大小与孕周相符,胎儿胸围增大,胸腔内左肺叶明显增大,呈团块状高回声,范围约为55 mm×53 mm,内部回声水平较肝脏明显增高,分布尚均匀,     

胎儿先天性肺囊腺瘤样畸形3例

孕妇1 25岁,孕21＋1周,未定期产检,来我院行产科四维超声筛查记录：胎儿生长指标与孕周相符,羊水指数在正常范围内,胎儿右侧胸腔内可见回声增强区．占据大部分胸腔,内可见多个无回声区,内透声好,测较大一个大小约11mm×9mm（图1）。胎儿心脏受压左移。超声提示：     

Fluid-filled cystic adenomatoid malformation.

Two infants with congenital cystic adenomatoid malformation of the lung are described. The condition progressed from an unusual solid radiographic appearance to the more classical air-filled cystic appearance. The initial appearance is due to delayed emptying of the alveolar fluid either via the bronchi or the lymphatic and circulatory systems. After the fluid is removed, the typical air-filled cysts become apparent.     

超声诊断胎儿肺囊性腺瘤样畸形1例

孕妇 ,2 3岁 ,孕 2 7周 ,Ｇ2 Ｐ0 。妇科检查 :宫底脐上 3横指 ,胎心音弱 ,规律 ,心率 1 38次 /分。自述胎动好 ,无传染病史及家族遗传病史。超声所见 :宫内单胎 ,ＬＯＴ位 ,双顶径7 0ｃｍ ,脊柱排列整齐 ,股骨长 4 .8ｃｍ。胎盘位于后壁 ,厚3 0ｃｍ ,成熟度Ｉ级。羊水过量 ,最深平面 8.4ｃｍ。胎儿胸腹腔饱满 ,右肺相应位置见一强回声团占据 ,范围 3 .7ｃｍ×5 5ｃｍ× 6 .5ｃｍ ,其内回声不均 ,贴近纵隔左侧显示一小弧形左肺回声。心脏受压而贴近左侧胸壁 ,膈肌下移 (图 1 ,2 )。胎儿腹部膨隆 ,腹腔内大量无回声暗区 ,范围为 1 .0ｃｍ×3 …     

胎儿肺囊性腺瘤样病变的超声诊断(附33例报告并文献复习)

目的探讨胎儿肺囊性腺瘤样病变(CCAM)的超声诊断价值及其预后情况。方法对我院2013年1月~2014年12月在产前超声检查中发现的33例胎儿先天性肺囊性腺瘤样病变的声像图征象及其随访结果进行回顾性分析。结果本组33例胎儿CCAM,左侧18例,右侧15例;Ⅰ型3例,Ⅱ型18例,Ⅲ型12例。随访过程中18例引产,1例出生后CT证实为肺隔离症,12例肿块逐渐减小直至消失,另2例失访。结论超声检查是诊断胎儿CCAM的重要手段,并可协助临床判断CCAM胎儿的预后与转归。     

Three-dimensional volume rendering of fetal MR images for the diagnosis of congenital cystic adenomatoid malformation

RATIONALE AND OBJECTIVES: Great expertise is necessary to mentally compile a series of individual two-dimensional image sections into a three-dimensional (3D) composite view that can aid in differential diagnosis. The purpose of this study was to test 3D volume-rendering techniques for differentiating congenital cystic adenomatoid malformation from congenital diaphragmatic hernia. MATERIALS AND METHODS: The authors acquired T2-weighted magnetic resonance (MR) images of a 27-week fetus in the sagittal plane and then applied the 3D volume-rendering method to the MR image data sets to obtain a composite 3D image. RESULTS: It was unclear on the MR images whether the intestines were situated above or below the diaphragm. The composite image showed that the intestines were not herniated into the chest, and this facilitated a diagnosis of congenital cystic adenomatoid malformation rather than congenital diaphragmatic hernia. CONCLUSION: The 3D volume-rendering techniques aided in the assessment of fetal organ structure and could be applied also to preoperative simulation and planning of fetal surgery.