胎儿卵巢囊肿蒂扭转产前和产后超声表现及病理对照

目的总结胎儿卵巢囊肿蒂扭转产前和产后超声声像图特征，并与出生后手术病理检查结果对照分析。 方法2013年1月至2017年6月在湖北省妇幼保健院产前超声检查的173 853例孕妇中发现胎儿卵巢囊肿蒂扭转5例（发生率0.003%，5/173 853），均于出生后手术病理检查证实。与手术病理检查结果对照，对胎儿卵巢囊肿蒂扭转产前及产后声像图特征进行总结分析。 结果产前超声显示5例胎儿均为单胎，外生殖器均为女性，晚孕期发现单侧单发腹（盆）腔肿瘤。其中单纯型囊肿1例，大小3.4 cm×2.6 cm×2.3 cm，无回声，囊壁薄；复杂型囊肿4例，大小3.4 cm×3.1 cm×2.4 cm~6.2 cm×5.9 cm×5.4 cm，均呈混合性回声，囊壁厚，囊肿内部均无血供。产后超声复查显示5例卵巢囊肿中1例缩小，4例增大，位置、囊内容物回声均发生改变，其中3例囊壁增厚、厚薄不均或钙化。手术探查显示5例卵巢囊肿均发生扭转坏死。病理镜检示卵巢囊肿出血性梗死部分伴有钙化。 结论胎儿期卵巢囊肿需在出生后复查，发现囊肿大小，位置，囊内容物发生改变时应考虑可能为卵巢囊肿蒂扭转，为临床合理诊治提供依据。

Study on the prenatal and postnatal ultrasound diagnosis of fetal ovarian cyst torsion compared with pathology

ObjectiveTo summarize the sonographic features of fetal ovarian cyst and compare with postnatal pathology results. MethodsA total of 173 853 fetuses were examined in our hospital from January 2013 to June 2017. Five of them were diagnosed with ovarian cyst torsion and then confirmed after birth. ResultsAll 5 cases were singleton, female, and unilateral. One of them was simple cyst with thin wall, and the other four were complex type cysts with thick wall and mixed echo inside. There was no blood supply inside the cyst. Ovarian torsion necrosis were confirmed during operation after birth, and hemorrhagic infarction with calcification were detected in all cases. ConclusionsFetal ovarian cyst torsion should be suspected, if the size, location and content of the cyst changed during follow up. It helps to make rational diagnosis and choose treatment.